| NPI | 1861628349 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: MA RN2310926) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: TX 636490) |
| 363L00000X Nurse Practitioner (Licence: MA RN2310926) | |
| Enumeration Date | 2009-06-10 |
| Last Update Date | 2022-11-18 |