| NPI | 1871917138 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: ME CNP141079) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MA 418379) |
| 363LA2200X Nurse Practitioner, Adult Health (Licence: ME 141079) | |
| Enumeration Date | 2014-02-06 |
| Last Update Date | 2014-10-07 |