| NPI | 1720179278 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: CA NPF23095) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: ME R050412) |
| 363LF0000X Nurse Practitioner, Family (Licence: NH 058363-23) | |
| Enumeration Date | 2006-09-28 |
| Last Update Date | 2016-03-25 |