| NPI | 1619452646 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: MA RN2326652) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MA RN2326652) |
| 363L00000X Nurse Practitioner (Licence: MA RN2326652) | |
| Enumeration Date | 2018-09-25 |
| Last Update Date | 2022-07-13 |