| NPI | 1508818964 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MA RN226334) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: RI CNP36200) |
| 363L00000X Nurse Practitioner (Licence: RI CNP36200) | |
| Enumeration Date | 2006-05-16 |
| Last Update Date | 2010-10-07 |