| NPI | 1184234841 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 164W00000X Licensed Practical Nurse (Licence: MA LN53455) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MA LN53455) |
| Enumeration Date | 2020-08-06 |
| Last Update Date | 2020-08-06 |