| NPI | 1881966000 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: RI APRN01686) |
| Additional Taxonomies | 163WD0400X Registered Nurse, Diabetes Educator (Licence: RI RN45450) |
| Enumeration Date | 2012-02-03 |
| Last Update Date | 2017-09-14 |