| NPI | 1568713618 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: MA RN2274297) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MA RN2274297) |
| 363LP0200X Nurse Practitioner, Pediatrics (Licence: NH 070772-23) | |
| Enumeration Date | 2012-09-28 |
| Last Update Date | 2017-05-04 |