| NPI | 1164811709 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: ME CNP221119) | 
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: LA AP08143) | 
| Enumeration Date | 2015-01-20 | 
| Last Update Date | 2022-08-02 |