| NPI | 1558117507 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MA RN2373698) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: ME CNP241163) |
| Enumeration Date | 2024-04-29 |
| Last Update Date | 2025-01-13 |