NPI | 1124576475 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: VT 101-0122885) |
Additional Taxonomies | 363LP2300X Nurse Practitioner Primary Care (Licence: VT 0122885) |
Enumeration Date | 2016-09-15 |
Last Update Date | 2021-12-23 |