| NPI | 1619593928 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: MA RN2326121) |
| Additional Taxonomies | 2088P0231X (Licence: MA RN2326121) |
| 363LP0200X Nurse Practitioner, Pediatrics (Licence: CT 8911) | |
| Enumeration Date | 2020-06-23 |
| Last Update Date | 2022-01-14 |