| NPI | 1164799862 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: MA RN2274966) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: ME RN54376) |
| 363LF0000X Nurse Practitioner Family (Licence: MD CNP111104) | |
| Enumeration Date | 2011-11-23 |
| Last Update Date | 2015-09-10 |