| NPI | 1114604469 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: VT 101-0136455) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: OR 202325774) |
| Enumeration Date | 2023-06-29 |
| Last Update Date | 2023-09-18 |