| NPI | 1063995611 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: RI APRN01946) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MA F08180881) |
| Enumeration Date | 2018-09-10 |
| Last Update Date | 2018-11-15 |