| NPI | 1326507310 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: MA RN2360306) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NC 280396) |
| Enumeration Date | 2019-03-18 |
| Last Update Date | 2022-02-18 |