| NPI | 1477564102 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: RI NPP36391) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MA RN239768) |
| Enumeration Date | 2006-08-10 |
| Last Update Date | 2020-06-29 |