| 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 |