| NPI | 1952865883 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: MA 2339263) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NC 5011387) |
| Enumeration Date | 2019-01-24 |
| Last Update Date | 2020-05-07 |