| NPI | 1962793927 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: TN 24842) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: ME AP111025) |
| 363LP0200X Nurse Practitioner, Pediatrics (Licence: MA RN2263076) | |
| Enumeration Date | 2011-04-26 |
| Last Update Date | 2019-02-27 |