| NPI | 1962669259 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: MA 198165) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MA RN198165) |
| Enumeration Date | 2008-05-22 |
| Last Update Date | 2025-01-06 |