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 |