| NPI | 1174890362 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: MA RN2374194) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MA RN2374194) |
| 363LF0000X Nurse Practitioner, Family (Licence: IL 209-009224) | |
| Enumeration Date | 2011-11-16 |
| Last Update Date | 2025-03-03 |