| NPI | 1104407725 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: RI APRN02701) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: MA RN2328733) |
| Enumeration Date | 2021-04-15 |
| Last Update Date | 2021-05-11 |