NPI | 1992177026 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MA RN2292099) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: ME CNP201480) |
363LF0000X Nurse Practitioner, Family (Licence: NH 084154-23) | |
Enumeration Date | 2015-10-28 |
Last Update Date | 2023-11-22 |