| NPI | 1578760310 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner Pediatrics (Licence: MA 2281271) |
| Additional Taxonomies | 133V00000X Dietitian, Registered |
| Enumeration Date | 2007-06-27 |
| Last Update Date | 2015-03-03 |