NPI | 1649609736 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: MA RN2311806) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MD R197255) |
Enumeration Date | 2013-11-08 |
Last Update Date | 2022-07-21 |