| NPI | 1366514762 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MA 96288) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: ME CNP81775) |
| Enumeration Date | 2006-11-14 |
| Last Update Date | 2015-06-09 |