| NPI | 1912253246 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner Adult Health (Licence: ME CNP201053) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner Adult Health (Licence: MA RN278529) |
| Enumeration Date | 2012-07-24 |
| Last Update Date | 2022-10-10 |