| NPI | 1073890562 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: VT 101.0135933FCTY) |
| Additional Taxonomies | 363LP2300X Nurse Practitioner, Primary Care (Licence: CT 004669) |
| 363LP2300X Nurse Practitioner, Primary Care (Licence: NJ 26NJ00337400) | |
| Enumeration Date | 2011-11-10 |
| Last Update Date | 2023-01-12 |