| NPI | 1730780669 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner Pediatrics (Licence: MA RN2286855) |
| Additional Taxonomies | 163WP0200X Registered Nurse Pediatrics (Licence: MA 2286855) |
| Enumeration Date | 2020-11-06 |
| Last Update Date | 2022-11-02 |