NPI | 1992259741 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: MA RN2302757) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: MA 2302757) |
363LP2300X Nurse Practitioner, Primary Care (Licence: CA NP95024813.) | |
Enumeration Date | 2016-08-10 |
Last Update Date | 2024-08-21 |