| NPI | 1093104119 | 
|---|---|
| Former Name | SARAH WENTWORTH | 
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: MA 2276958) | 
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: CT 6050) | 
| Enumeration Date | 2015-01-13 | 
| Last Update Date | 2022-07-21 |