| NPI | 1134527815 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: VT 101-0136323) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MA RN2283755) |
| 363LF0000X Nurse Practitioner, Family (Licence: MA RN2283755) | |
| Enumeration Date | 2014-12-12 |
| Last Update Date | 2023-12-14 |