| NPI | 1730351909 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MA RN204637)  | 
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: MA RN204637)  | 
| Enumeration Date | 2008-03-28 | 
| Last Update Date | 2020-11-09 |