| NPI | 1629046644 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner Pediatrics (Licence: MA 126600) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MA 126600) |
| Enumeration Date | 2006-03-08 |
| Last Update Date | 2011-03-10 |