| NPI | 1700393394 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: RI APRN04116) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: PA SP018433) |
| 363LP0200X Nurse Practitioner, Pediatrics (Licence: MA RN2288750) | |
| Enumeration Date | 2018-01-04 |
| Last Update Date | 2024-08-07 |