| NPI | 1609420926 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: MA 201914046) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MA RN2320206) |
| Enumeration Date | 2019-07-25 |
| Last Update Date | 2019-07-25 |