| NPI | 1780213413 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: ME CNP231219) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TX 1107729) |
| 363LF0000X Nurse Practitioner, Family (Licence: NM 73102) | |
| Enumeration Date | 2020-04-04 |
| Last Update Date | 2023-06-30 |