| NPI | 1245494095 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: ME CNP81912) | 
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: ME R053034) | 
| Enumeration Date | 2008-07-10 | 
| Last Update Date | 2020-11-16 |