| NPI | 1770066961 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: CA 95032513) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: MA RN264027) |
| 363LP0200X Nurse Practitioner, Pediatrics (Licence: CT 7849) | |
| Enumeration Date | 2018-09-13 |
| Last Update Date | 2025-08-13 |