| NPI | 1033261532 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MA RN2315040)  | 
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: CA 16502)  | 
| 363LF0000X Nurse Practitioner, Family (Licence: RI APRN01738)  | |
| 363LF0000X Nurse Practitioner, Family (Licence: MA RN2315040)  | |
| Enumeration Date | 2007-01-17 | 
| Last Update Date | 2018-05-23 |