NPI | 1912450966 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MA RN2281066) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: CT 9439) |
Enumeration Date | 2016-07-26 |
Last Update Date | 2025-03-12 |