| NPI | 1255509014 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: VT 1010134431) | 
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: IL 209006889) | 
| 363LP2300X Nurse Practitioner, Primary Care (Licence: IL 209006889) | |
| Enumeration Date | 2008-02-14 | 
| Last Update Date | 2023-12-12 |