| NPI | 1205229135 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: ME CNP191272) | 
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: CO APN.0991682-NP) | 
| Enumeration Date | 2015-03-17 | 
| Last Update Date | 2021-01-20 |