| NPI | 1124454590 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: RI APRN00635) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MA RN260529) |
| Enumeration Date | 2013-09-17 |
| Last Update Date | 2015-03-23 |