| NPI | 1164772893 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: OR 201402108NP-PP) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: VT 101.0097262) |
| Enumeration Date | 2012-09-10 |
| Last Update Date | 2023-10-23 |