| NPI | 1689104168 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0200X Nurse Practitioner Pediatrics (Licence: MA RN2314769) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MA RN2314769) |
| Enumeration Date | 2017-06-15 |
| Last Update Date | 2021-12-27 |