| NPI | 1619953312 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner Adult Health (Licence: ME CNP121078) |
| Additional Taxonomies | 364S00000X Clinical Nurse Specialist (Licence: CT 001556) |
| Enumeration Date | 2005-12-15 |
| Last Update Date | 2014-10-23 |