| NPI | 1114034238 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LA2200X Nurse Practitioner Adult Health (Licence: NH 014489-23-05) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner Adult Health (Licence: VT 101.0022507) |
| Enumeration Date | 2006-08-24 |
| Last Update Date | 2014-10-20 |