| NPI | 1336149459 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: CT 9670) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: RI NPPP32448) |
| Enumeration Date | 2005-07-29 |
| Last Update Date | 2021-05-18 |