| NPI | 1104173632 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NY F342969) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: ME CNP121060) |
| Enumeration Date | 2012-08-15 |
| Last Update Date | 2018-05-31 |