NPI | 1871119628 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MA RN2390906) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MA RN2390906) |
363LF0000X Nurse Practitioner, Family (Licence: FL APRN11007401) | |
Enumeration Date | 2020-06-17 |
Last Update Date | 2024-05-20 |