| NPI | 1154566636 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: NH 066587-23) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: CT 4828) |
| 363LP0200X Nurse Practitioner, Pediatrics (Licence: MA RN285467) | |
| Enumeration Date | 2008-12-11 |
| Last Update Date | 2022-09-09 |