| NPI | 1336692870 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MA RN2286207) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: RI APRN01989) |
| Enumeration Date | 2016-08-02 |
| Last Update Date | 2019-02-08 |