| NPI | 1578123212 |
|---|---|
| Former Name | ABIGAIL PECKHAM |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NY 345003) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| Enumeration Date | 2019-06-14 |
| Last Update Date | 2025-07-18 |