Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0120X | Pediatric Surgery | MD21169 | ME |
NPI | 1407197692 |
---|---|
Provider Name | Mrs. Nathalie L Brewer |
First Address | Brewer, ME 04412-1006 |
Second Address | Bangor, ME 04401 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/03/2013 |
Last Update Date | 09/07/2019 |