NPI | 1104242148 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LN0005X Nurse Practitioner, Neonatal, Critical Care (Licence: MA RN2260353) |
Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: MA RN2260353) |
363L00000X Nurse Practitioner (Licence: MA RN2260353) | |
Enumeration Date | 2014-03-14 |
Last Update Date | 2021-10-27 |