| NPI | 1609317288 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MA RN2299264) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MA RN2299264) |
| 363LP0200X Nurse Practitioner, Pediatrics (Licence: MA RN2299264) | |
| Enumeration Date | 2017-03-15 |
| Last Update Date | 2022-03-17 |