NPI | 1790264828 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MA RN2306004) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IN 71008213A) |
Enumeration Date | 2018-08-09 |
Last Update Date | 2021-02-12 |