| NPI | 1619940285 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner Pediatrics (Licence: MA 163712) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MA 163712) |
| Enumeration Date | 2006-02-13 |
| Last Update Date | 2012-06-11 |