NPI | 1831639319 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MA RN10010012) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: VT 101.0128344) |
Enumeration Date | 2017-03-02 |
Last Update Date | 2025-03-04 |