| NPI | 1083722623 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NC 5007834) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: VT 101-0014543) |
| Enumeration Date | 2006-08-25 |
| Last Update Date | 2022-12-16 |