| NPI | 1124210570 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: VT 101.0134176) |
| Additional Taxonomies | 364S00000X Clinical Nurse Specialist (Licence: IL 209-001476) |
| Enumeration Date | 2007-08-09 |
| Last Update Date | 2018-11-09 |