| NPI | 1578815486 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: MA RN2282081) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NH 080336-21) |
| 163WP0200X Registered Nurse, Pediatrics (Licence: MA RN2282081) | |
| 163WP0200X Registered Nurse, Pediatrics (Licence: NY 22 643553) | |
| 363LP0200X Nurse Practitioner, Pediatrics (Licence: NH 080336-23) | |
| 363LP0200X Nurse Practitioner, Pediatrics (Licence: NY 382351) | |
| Enumeration Date | 2012-10-03 |
| Last Update Date | 2019-10-25 |