| NPI | 1114451549 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NH 075439-23) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: VT 026.0035067) |
| 363L00000X Nurse Practitioner (Licence: NH 075439-21) | |
| Enumeration Date | 2017-04-12 |
| Last Update Date | 2017-04-12 |