| NPI | 1073174462 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MA RN2286437) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner Pediatrics (Licence: MA RN2286437) |
| Enumeration Date | 2019-06-26 |
| Last Update Date | 2020-10-26 |