| NPI | 1386384600 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: MA RN2292616) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: MA applying) |
| Enumeration Date | 2022-04-01 |
| Last Update Date | 2022-04-01 |