| NPI | 1619367091 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: RI APRN00612) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: MA RN2263122) |
| Enumeration Date | 2015-01-23 |
| Last Update Date | 2016-03-31 |