| NPI | 1245616796 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MA RN2286933) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MA RN2286933) |
| 163W00000X Registered Nurse (Licence: RI RN53121) | |
| 363LP0200X Nurse Practitioner, Pediatrics (Licence: MA APRN2286933) | |
| Enumeration Date | 2015-08-07 |
| Last Update Date | 2022-04-15 |