| NPI | 1790804433 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: RI NPP37658) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: MA 206157) |
| Enumeration Date | 2007-03-27 |
| Last Update Date | 2012-01-09 |