| NPI | 1306220090 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MA RN2276739) |
| Additional Taxonomies | 163WP0200X Registered Nurse, Pediatrics (Licence: NY 653577) |
| 363LP0200X Nurse Practitioner, Pediatrics (Licence: MA RN2276739) | |
| Enumeration Date | 2015-07-13 |
| Last Update Date | 2019-07-19 |