| NPI | 1184902967 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: VT 101.0080154) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: CT 004988) |
| Enumeration Date | 2011-07-28 |
| Last Update Date | 2014-12-08 |