| NPI | 1740670421 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: ME CNP181199) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TX 736195) |
| Enumeration Date | 2015-02-02 |
| Last Update Date | 2018-08-29 |