| NPI | 1891054490 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: NH 060192-23) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: MA 197542) |
| Enumeration Date | 2012-05-16 |
| Last Update Date | 2018-02-05 |