| NPI | 1053741991 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: MA RN2270016) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MA RN2270016) |
| 163W00000X Registered Nurse (Licence: TN RN0000195893) | |
| 363LP0200X Nurse Practitioner, Pediatrics (Licence: TN 18240) | |
| Enumeration Date | 2013-11-13 |
| Last Update Date | 2019-09-04 |