NPI | 1164811709 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: ME CNP221119) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: LA AP08143) |
Enumeration Date | 2015-01-20 |
Last Update Date | 2022-08-02 |