| NPI | 1144882739 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MA RN2316486) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: MA RN2316486) |
| 163W00000X Registered Nurse (Licence: MA RN2316486) | |
| Enumeration Date | 2019-07-03 |
| Last Update Date | 2022-06-14 |