| NPI | 1780121293 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner Pediatrics (Licence: MA 283535) |
| Additional Taxonomies | 163WP0200X Registered Nurse Pediatrics (Licence: MA 283535) |
| Enumeration Date | 2017-01-22 |
| Last Update Date | 2018-03-17 |