| NPI | 1396077632 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MT 100639) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: ME CNP151207) |
| 363LF0000X Nurse Practitioner, Family (Licence: NH 073291-23) | |
| Enumeration Date | 2010-02-11 |
| Last Update Date | 2017-12-12 |