| NPI | 1639142573 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: MA 129597) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MA 129597) |
| Enumeration Date | 2006-02-10 |
| Last Update Date | 2021-01-28 |