| NPI | 1235579970 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: ME CNP161150) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MA RN2281034) |
| 163W00000X Registered Nurse (Licence: ME RN67695) | |
| 363LA2200X Nurse Practitioner, Adult Health (Licence: MA RN2281034) | |
| Enumeration Date | 2013-06-26 |
| Last Update Date | 2016-09-23 |