| NPI | 1043971757 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NC 5015780) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: VT 101.0135055) |
| Enumeration Date | 2022-01-05 |
| Last Update Date | 2023-02-01 |