| NPI | 1760178867 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: MA RN2358299) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 163W00000X Registered Nurse (Licence: MA RN2358299) | |
| Enumeration Date | 2023-04-12 |
| Last Update Date | 2024-11-22 |