| NPI | 1629476817 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: RI APRN00087) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: MA RN2259050) |
| 363LW0102X Nurse Practitioner, Women's Health (Licence: MA RN2259050) | |
| 363LW0102X Nurse Practitioner, Women's Health (Licence: RI APRN00087) | |
| Enumeration Date | 2014-12-20 |
| Last Update Date | 2015-01-29 |