NPI | 1710376447 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MA RN276961) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NC 5007402) |
Enumeration Date | 2015-01-19 |
Last Update Date | 2017-01-20 |