| NPI | 1205363090 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MA RN2280443) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: RI APRN01615) |
| 363LF0000X Nurse Practitioner, Family (Licence: MA RN2280443) | |
| Enumeration Date | 2017-05-11 |
| Last Update Date | 2021-04-15 |