NPI | 1154994069 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: MA RN2384969) |
Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: NC 5014747) |
Enumeration Date | 2021-07-19 |
Last Update Date | 2023-08-21 |