| NPI | 1255931150 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MA RN2294001) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: RI APRN02497) |
| Enumeration Date | 2020-10-29 |
| Last Update Date | 2024-09-08 |