| NPI | 1477065035 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: MA RN2310710) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MA RN2310710) |
| 363LP0200X Nurse Practitioner, Pediatrics (Licence: CT 7364) | |
| Enumeration Date | 2017-11-03 |
| Last Update Date | 2022-09-09 |