| NPI | 1386720175 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: MA RN2269575) |
| Additional Taxonomies | 363LP0222X Nurse Practitioner, Pediatrics, Critical Care (Licence: NC 5003911) |
| 363L00000X Nurse Practitioner (Licence: PA TP006200D) | |
| Enumeration Date | 2006-10-27 |
| Last Update Date | 2013-07-09 |