NPI | 1942852868 |
---|---|
Former Name | LELA NELSON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MA MCS001212B) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: IL 041.25349) |
Enumeration Date | 2019-07-11 |
Last Update Date | 2021-09-21 |