NPI | 1790462265 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MA RN2326805) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NH 091043-23) |
Enumeration Date | 2023-06-28 |
Last Update Date | 2023-06-28 |