| NPI | 1386282549 |
|---|---|
| Former Name | TRISHA BEA MAYNARD |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: SD F12190134) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: SD F12190134) |
| Enumeration Date | 2019-12-18 |
| Last Update Date | 2023-03-17 |