| NPI | 1154397206 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: VT 101-0118554) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MA 177220) |
| Enumeration Date | 2006-02-28 |
| Last Update Date | 2016-07-29 |