| NPI | 1659636611 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: ME CNP171041) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NH 066201-21) |
| 363LF0000X Nurse Practitioner, Family (Licence: NH 066201-23) | |
| Enumeration Date | 2012-07-05 |
| Last Update Date | 2024-03-01 |