| NPI | 1003623356 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: RI APRN04362)  | 
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MA RN2336344)  | 
| 363LF0000X Nurse Practitioner, Family (Licence: RI APRN04362)  | |
| Enumeration Date | 2024-12-11 | 
| Last Update Date | 2025-07-15 |