| NPI | 1356623375 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: MA RN2258814) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: PA SP011552) |
| Enumeration Date | 2011-09-15 |
| Last Update Date | 2013-09-27 |