| NPI | 1548286834 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: MA 120744) | 
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: RI NP15446) | 
| 363L00000X Nurse Practitioner (Licence: MA 120744) | |
| Enumeration Date | 2006-07-14 | 
| Last Update Date | 2014-06-11 |