| NPI | 1871197731 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MA RN2362337) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: RI RN68176) |
| Enumeration Date | 2020-11-22 |
| Last Update Date | 2022-05-10 |