| NPI | 1104200187 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: NY 382648) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MA RN2305976) |
| 163W00000X Registered Nurse (Licence: NY 688119) | |
| 363LP0200X Nurse Practitioner, Pediatrics (Licence: MA RN2305976) | |
| Enumeration Date | 2015-07-19 |
| Last Update Date | 2019-11-20 |