| NPI | 1538566393 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: ME CNP171163) | 
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: WA AP60522739) | 
| Enumeration Date | 2014-11-21 | 
| Last Update Date | 2018-11-26 |