| NPI | 1104028943 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: ME AP111046) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MA 2265442) |
| Enumeration Date | 2007-06-04 |
| Last Update Date | 2012-10-16 |