| NPI | 1194363267 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163WC1500X Registered Nurse Community Health (Licence: MA RN200984) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner Pediatrics (Licence: MA 201912843) |
| Enumeration Date | 2019-12-19 |
| Last Update Date | 2019-12-19 |