| NPI | 1124680707 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: ME CNP201281) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: VT 101.0134354) |
| Enumeration Date | 2019-07-03 |
| Last Update Date | 2023-11-27 |