| NPI | 1053819573 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: MA RN2313383) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MA RN2313383) |
| Enumeration Date | 2018-01-30 |
| Last Update Date | 2019-05-17 |