| NPI | 1164503660 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: VT 101.0110430) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: NH 063039-23) |
| Enumeration Date | 2006-10-18 |
| Last Update Date | 2015-07-13 |