| NPI | 1336250745 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner Pediatrics (Licence: ME CNP141083) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: ME R039532) |
| 363LP0200X Nurse Practitioner Pediatrics (Licence: NC 0050-03139) | |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2016-05-13 |