NPI | 1669604112 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: ME CNP131048) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MA RN241510) |
363LF0000X Nurse Practitioner, Family (Licence: NH 048111-23) | |
Enumeration Date | 2009-08-18 |
Last Update Date | 2018-07-17 |