NPI | 1992766554 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MA 133975) |
Additional Taxonomies | 363LA2200X Nurse Practitioner Adult Health (Licence: MA 133975) |
Enumeration Date | 2006-03-31 |
Last Update Date | 2007-07-08 |