NPI | 1104802313 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: MN 10319) |
Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: ME R95775) |
363LA2200X Nurse Practitioner, Adult Health (Licence: ME CNP8112) | |
Enumeration Date | 2005-12-20 |
Last Update Date | 2024-08-06 |