| NPI | 1255614624 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: OR 201503865NP-PP) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: VT 101.0081248) |
| 363LF0000X Nurse Practitioner, Family (Licence: CT 005019) | |
| Enumeration Date | 2011-09-22 |
| Last Update Date | 2022-06-06 |