| NPI | 1194248278 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CA 95007360) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: VT 026.0106285) |
| 363LF0000X Nurse Practitioner, Family (Licence: VT 101.0129218) | |
| Enumeration Date | 2017-07-20 |
| Last Update Date | 2021-02-23 |