NPI | 1770362071 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: MA RN2310150) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MA RN2310150) |
Enumeration Date | 2023-09-26 |
Last Update Date | 2024-10-21 |