| 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 | 2025-10-06 |