| NPI | 1043756489 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: ME CNP211476) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: IL 041416041) |
| 363L00000X Nurse Practitioner (Licence: IL 209014946) | |
| Enumeration Date | 2017-01-09 |
| Last Update Date | 2021-11-02 |