| NPI | 1063150100 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: RI APRN04296) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MA RN2326397) |
| Enumeration Date | 2022-05-26 |
| Last Update Date | 2024-11-07 |