| NPI | 1629446133 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NH 061496-23) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: ME CNP211101) |
| 363L00000X Nurse Practitioner (Licence: MA RN2352132) | |
| Enumeration Date | 2015-09-14 |
| Last Update Date | 2023-12-21 |