| NPI | 1164980082 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: VT 101.0134392) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: VT 026.0021185) |
| Enumeration Date | 2019-03-10 |
| Last Update Date | 2019-11-15 |