| NPI | 1487924643 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: CA 95000938) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: MA RN264689) |
| Enumeration Date | 2012-01-05 |
| Last Update Date | 2018-12-13 |