| NPI | 1790921609 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: MA RN237840) | 
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: RI APRN03444) | 
| 363L00000X Nurse Practitioner (Licence: WA AP60070033) | |
| Enumeration Date | 2008-12-23 | 
| Last Update Date | 2024-05-23 |