NPI | 1912405341 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MA RN2306879) |
Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: MA RN2306879) |
Enumeration Date | 2018-01-31 |
Last Update Date | 2018-09-20 |