| NPI | 1649603093 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: CA 95008818) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: ME CNP131059) |
| Enumeration Date | 2013-08-20 |
| Last Update Date | 2023-05-16 |