NPI | 1790143048 |
---|---|
Former Name | REBECCA LYNN HAKANSSON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: MA RN2298431) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: MA RN2298431) |
Enumeration Date | 2016-02-02 |
Last Update Date | 2019-08-02 |