| NPI | 1184504904 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: MA 202530030) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: MN 202530030) |
| Enumeration Date | 2025-09-03 |
| Last Update Date | 2025-09-03 |