| NPI | 1689945420 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: ME CNP151089) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: TX 846102) |
| 363LA2200X Nurse Practitioner, Adult Health (Licence: CT 004742) | |
| Enumeration Date | 2012-01-25 |
| Last Update Date | 2021-03-30 |