| NPI | 1902484587 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: ME CNP241470)  | 
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CA 95016926)  | 
| 363L00000X Nurse Practitioner (Licence: CA 95016916)  | |
| Enumeration Date | 2021-04-01 | 
| Last Update Date | 2024-09-05 |