NPI | 1932761368 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: MA RN2291385) |
Additional Taxonomies | 163WP0200X Registered Nurse, Pediatrics (Licence: MA RN2291385) |
Enumeration Date | 2019-07-06 |
Last Update Date | 2020-05-13 |