| NPI | 1962249102 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: MA RN10003886) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MA RN10003886) |
| Enumeration Date | 2024-07-15 |
| Last Update Date | 2026-07-14 |