| NPI | 1164913182 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: MA RN2306567) |
| Additional Taxonomies | 163WP0200X Registered Nurse, Pediatrics (Licence: MA RN2306567) |
| Enumeration Date | 2018-05-24 |
| Last Update Date | 2020-01-15 |