| NPI | 1912452871 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MA RN2276957) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MA RN2276957) |
| 363LP0200X Nurse Practitioner, Pediatrics (Licence: MA RN2276957) | |
| Enumeration Date | 2016-08-22 |
| Last Update Date | 2018-10-19 |