NPI | 1972208072 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: MA RN2377000) |
Additional Taxonomies | 163WP0200X Registered Nurse, Pediatrics (Licence: MA RN2377000) |
Enumeration Date | 2023-03-30 |
Last Update Date | 2024-04-07 |