| NPI | 1912199217 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: MA 231679) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: NH 062444-23) |
| Enumeration Date | 2007-08-10 |
| Last Update Date | 2018-10-23 |