NPI | 1982036877 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: MA RN27705) |
Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: MA 363L00000X) |
Enumeration Date | 2013-08-02 |
Last Update Date | 2017-05-12 |