NPI | 1922312420 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MA RN2311879) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: SC 4175) |
363LF0000X Nurse Practitioner, Family (Licence: UT 8995618-4405) | |
Enumeration Date | 2010-07-27 |
Last Update Date | 2023-09-22 |