| NPI | 1568022416 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: CT 8787) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: RI RN58019) |
| Enumeration Date | 2019-06-13 |
| Last Update Date | 2020-07-07 |