NPI | 1396567871 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: MA RN2376585) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MA RN2376585) |
Enumeration Date | 2024-10-28 |
Last Update Date | 2024-11-05 |