| NPI | 1790912400 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: RI APRN00555) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MA RN-TEMP0511) |
| 363LA2200X Nurse Practitioner, Adult Health (Licence: NY 30 305129) | |
| Enumeration Date | 2009-06-19 |
| Last Update Date | 2020-08-25 |