| NPI | 1124189790 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: ME CNP81840) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: ME r053966) |
| Enumeration Date | 2006-12-13 |
| Last Update Date | 2012-08-13 |