| NPI | 1104406776 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: VT 101.0135526) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: NH 067166-23) |
| 363LF0000X Nurse Practitioner Family (Licence: MA RN2323643) | |
| Enumeration Date | 2021-04-08 |
| Last Update Date | 2024-08-27 |