| NPI | 1912028788 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: ME CNP111081) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: MA 254247) |
| Enumeration Date | 2007-04-02 |
| Last Update Date | 2014-03-12 |