NPI | 1831765296 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MA RN2314539) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MA RN2314539) |
Enumeration Date | 2021-05-27 |
Last Update Date | 2021-07-09 |