| NPI | 1720656655 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: OR 202107827NP-PP) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: ME CNP251127) |
| 163W00000X Registered Nurse (Licence: OR 201505014RN) | |
| Enumeration Date | 2021-06-16 |
| Last Update Date | 2026-04-07 |