NPI | 1164078796 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: RI APRN04700) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: VT 101.0134388) |
363LF0000X Nurse Practitioner, Family (Licence: WI 1215233) | |
Enumeration Date | 2019-08-09 |
Last Update Date | 2025-08-25 |