Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080A0000X | Adolescent Medicine | R032038 | ME |
NPI | 1013002534 |
---|---|
Provider Name | Jennifer Power |
First Address | Falmouth, ME 04105 |
Second Address | Yarmouth, ME 04096 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/10/2006 |
Last Update Date | 09/07/2007 |