NPI | 1720794514 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MA RN2293376) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NH 070317-23) |
Enumeration Date | 2023-01-25 |
Last Update Date | 2023-02-02 |