| NPI | 1730888009 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: MA RN2333066) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner Pediatrics (Licence: MA RN2333066) |
| Enumeration Date | 2023-02-27 |
| Last Update Date | 2024-09-01 |