| NPI | 1861894941 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HOLLY DUMAINE-PICARD Credentialing Coordinator 401-770-9323 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MN 2014010271) |
| Enumeration Date | 2014-09-21 |
| Last Update Date | 2014-09-21 |