| NPI | 1417520636 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: MA RN2319961) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MA RN2319961) |
| 363LP2300X Nurse Practitioner, Primary Care (Licence: MA RN2319961) | |
| Enumeration Date | 2021-07-24 |
| Last Update Date | 2023-07-19 |