| NPI | 1730282385 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: ME CNP81836) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: ME R030879) |
| 163WR0006X Registered Nurse, Registered Nurse First Assistant (Licence: ME CNP81836) | |
| Enumeration Date | 2006-09-07 |
| Last Update Date | 2025-02-03 |