| NPI | 1508938002 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: MA RN2291800) |
| Additional Taxonomies | 163WP0200X Registered Nurse, Pediatrics (Licence: ME RO34895) |
| 363L00000X Nurse Practitioner (Licence: ME RO34895) | |
| 363L00000X Nurse Practitioner (Licence: MA RN2291800) | |
| Enumeration Date | 2006-11-14 |
| Last Update Date | 2016-02-23 |