NPI | 1114566312 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: MA RN2300662) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MA RN2300662) |
Enumeration Date | 2020-01-06 |
Last Update Date | 2022-11-28 |