| NPI | 1629615554 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: ME CNP211465) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MA RN2337602) |
| Enumeration Date | 2019-12-10 |
| Last Update Date | 2021-12-21 |