| NPI | 1700883568 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MA RN2296293) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: RI NPP37249) |
| Enumeration Date | 2005-07-07 |
| Last Update Date | 2015-02-18 |