| NPI | 1790258655 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: RI APRN03200) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: PA SP019721) |
| Enumeration Date | 2019-01-03 |
| Last Update Date | 2022-09-14 |