| NPI | 1689124109 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: RI APRN01627) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MA 1170573) |
| 363LP0200X Nurse Practitioner, Pediatrics (Licence: MA 20162082) | |
| Enumeration Date | 2016-10-07 |
| Last Update Date | 2022-07-21 |