| NPI | 1629552799 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: WV 114025) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: ME CNP181231) |
| Enumeration Date | 2018-09-24 |
| Last Update Date | 2023-06-14 |