NPI | 1720458367 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NH 071014-23) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MA RN2291098) |
Enumeration Date | 2015-09-25 |
Last Update Date | 2020-12-01 |