| NPI | 1396992012 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: MA RN2265055) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: NY 382001) |
| 363LP0200X Nurse Practitioner, Pediatrics (Licence: PA SP012383) | |
| Enumeration Date | 2008-08-25 |
| Last Update Date | 2023-02-17 |