| NPI | 1164782819 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: ME CNP141002) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: NY F336611-1) |
| Enumeration Date | 2012-05-29 |
| Last Update Date | 2017-02-15 |