| NPI | 1639681414 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: NY 383313) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MA RN2311946) |
| 363LP0200X Nurse Practitioner, Pediatrics (Licence: MA RN2311946) | |
| Enumeration Date | 2017-11-01 |
| Last Update Date | 2021-10-28 |