| NPI | 1053796144 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: VT 101.0121620) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: CT 6170) |
| Enumeration Date | 2015-07-30 |
| Last Update Date | 2023-12-19 |