| NPI | 1790326023 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: MA 2320455) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MA 2320455) |
| 163W00000X Registered Nurse (Licence: RI 61201) | |
| 363LP0200X Nurse Practitioner, Pediatrics (Licence: RI 02216) | |
| Enumeration Date | 2019-10-08 |
| Last Update Date | 2021-10-25 |