| NPI | 1639848591 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: MA RN2345178) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: RI RN67134) |
| 363L00000X Nurse Practitioner (Licence: RI APRN02885) | |
| Enumeration Date | 2021-09-13 |
| Last Update Date | 2023-04-19 |