| NPI | 1568836765 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MA RN279040) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NM CNP 02735) |
| 363LF0000X Nurse Practitioner, Family (Licence: RI APRN02239) | |
| 363L00000X Nurse Practitioner (Licence: RI APRN02239) | |
| 163W00000X Registered Nurse (Licence: NM CNP-02735) | |
| Enumeration Date | 2015-11-25 |
| Last Update Date | 2026-09-01 |