| NPI | 1508376930 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner Pediatrics (Licence: MA RN2310422) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MA RN2310422) |
| Enumeration Date | 2017-10-12 |
| Last Update Date | 2022-07-06 |