| NPI | 1073803144 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: ME CNP131126) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MN R200997-3) |
| Enumeration Date | 2011-04-11 |
| Last Update Date | 2018-10-03 |