NPI | 1891026506 |
---|---|
Former Name | MARY PATRICIA MCGOVERN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: MA 225188) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MA RN225188) |
Enumeration Date | 2010-01-20 |
Last Update Date | 2017-04-13 |