| NPI | 1306931019 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner Pediatrics (Licence: MA 166328) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner Pediatrics (Licence: RI CNPP37485) |
| Enumeration Date | 2006-10-04 |
| Last Update Date | 2012-08-14 |