| NPI | 1528787728 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: MA RN2348548) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: CT 173110) |
| 163W00000X Registered Nurse (Licence: MA RN2348548) | |
| Enumeration Date | 2022-08-23 |
| Last Update Date | 2022-09-26 |