| NPI | 1164972139 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: SC APRN28506) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: RI APRN01597) |
| 363LF0000X Nurse Practitioner, Family (Licence: NC 5009009) | |
| 363LF0000X Nurse Practitioner, Family (Licence: RI APRN01597) | |
| Enumeration Date | 2016-10-13 |
| Last Update Date | 2024-07-08 |