| NPI | 1538712997 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: RI APRN03540) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MA RN2320463) |
| 363LP0200X Nurse Practitioner, Pediatrics (Licence: MA 201913783) | |
| Enumeration Date | 2019-07-24 |
| Last Update Date | 2023-04-27 |