NPI | 1811376072 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: ME CNP191079) |
Additional Taxonomies | 207QA0505X Family Medicine, Adult Medicine (Licence: VT 101.0109859) |
Enumeration Date | 2015-05-21 |
Last Update Date | 2024-01-02 |