| NPI | 1790517084 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: ME CNP251832) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MS 906463) |
| Enumeration Date | 2024-08-15 |
| Last Update Date | 2026-04-22 |