NPI | 1679581417 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CT 005052) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: RI APRN01166) |
Enumeration Date | 2006-08-04 |
Last Update Date | 2016-04-01 |