| NPI | 1558761775 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: ME CNP171193) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NH 04932423) |
| 208000000X Pediatrics (Licence: NH 049324-23) | |
| Enumeration Date | 2014-08-25 |
| Last Update Date | 2018-04-27 |