NPI | 1700939188 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MA 192546) |
Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: MA 192546) |
Enumeration Date | 2007-01-19 |
Last Update Date | 2010-07-29 |