| NPI | 1417103193 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: MA RN246327) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: CT 003835) |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MA RN246327) | |
| Enumeration Date | 2008-08-13 |
| Last Update Date | 2022-02-23 |