| NPI | 1790879682 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: ME CNP81373) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: ME R048123) |
| Enumeration Date | 2006-10-03 |
| Last Update Date | 2014-04-17 |