| NPI | 1982755294 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MA 260214) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: RI NP36931) |
| Enumeration Date | 2007-01-15 |
| Last Update Date | 2007-07-08 |