| NPI | 1295285278 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: MA RN2372845) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: NM CNP-03085) |
| 363LP0200X Nurse Practitioner, Pediatrics (Licence: VT 101.0134628) | |
| Enumeration Date | 2016-10-13 |
| Last Update Date | 2023-03-15 |