NPI | 1891136636 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MA RN2380680) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: AL 1087141) |
Enumeration Date | 2013-07-09 |
Last Update Date | 2024-02-02 |