| NPI | 1487210068 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: RI APRN02057) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: MA RN202339) |
| Enumeration Date | 2019-05-19 |
| Last Update Date | 2019-05-23 |