NPI | 1891355715 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MA RN2333574) |
Additional Taxonomies | 2080P0206X Pediatrics, Pediatric Gastroenterology (Licence: DC RN1019272) |
Enumeration Date | 2019-06-13 |
Last Update Date | 2019-09-25 |