| NPI | 1215947593 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: NH 040582-23-02) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: MA 141546) |
| Enumeration Date | 2006-08-09 |
| Last Update Date | 2012-01-16 |