| NPI | 1629592035 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: MA RN2259476) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MA Rn2259476) |
| Enumeration Date | 2017-07-27 |
| Last Update Date | 2022-04-07 |