NPI | 1558992552 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: ME CNP221665) |
Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: MA 2300770) |
Enumeration Date | 2020-01-28 |
Last Update Date | 2023-03-06 |