| NPI | 1477623395 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: RI APRN01462) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MA RN2284487) |
| 2255A2300X Specialist/Technologist Athletic Trainer (Licence: MA 1631) | |
| 363L00000X Nurse Practitioner (Licence: MA RN2284487) | |
| Enumeration Date | 2006-11-08 |
| Last Update Date | 2018-09-18 |