NPI | 1700349362 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LA2100X Nurse Practitioner, Acute Care (Licence: MA RN2297161) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MA RN2297161) |
363LF0000X Nurse Practitioner, Family (Licence: MA RN2297161) | |
363LF0000X Nurse Practitioner, Family (Licence: RI APRN01868) | |
Enumeration Date | 2019-04-10 |
Last Update Date | 2022-10-31 |