NPI | 1790243921 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CT 010427) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MA 2018057880) |
Enumeration Date | 2019-03-06 |
Last Update Date | 2024-02-18 |