| NPI | 1174509764 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: ME AP081495) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: ME R017604) |
| Enumeration Date | 2005-12-16 |
| Last Update Date | 2019-10-24 |