| NPI | 1649622184 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: RI APRN01438) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: RI RN55323) |
| 163WP0200X Registered Nurse, Pediatrics (Licence: MA RN2299166) | |
| Enumeration Date | 2016-07-08 |
| Last Update Date | 2021-04-15 |