| NPI | 1134976103 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NY 406256) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: VT 101.0137088) |
| Enumeration Date | 2024-05-06 |
| Last Update Date | 2024-11-12 |