| NPI | 1710067087 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: ME CNP141026) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: NY F303154-1) |
| Enumeration Date | 2006-10-17 |
| Last Update Date | 2020-12-08 |