| NPI | 1679315766 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: MA RN10026153) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: CT 13745) |
| Enumeration Date | 2024-06-10 |
| Last Update Date | 2025-11-07 |