| NPI | 1568084093 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: PA SP025697) | 
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: ME CNP201190) | 
| Enumeration Date | 2020-05-06 | 
| Last Update Date | 2022-07-07 |