| NPI | 1194071514 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: MA RN2270557) |
| Additional Taxonomies | 163WA2000X Registered Nurse, Administrator (Licence: MA RN2270557) |
| Enumeration Date | 2012-08-03 |
| Last Update Date | 2019-12-02 |