| NPI | 1770685802 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: RI NPP32093) |
| Additional Taxonomies | 363LG0600X Nurse Practitioner, Gerontology (Licence: RI NPP32093) |
| Enumeration Date | 2006-09-01 |
| Last Update Date | 2012-11-06 |