| NPI | 1265118624 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: VT 101.0136498) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: VT 026.0143658) |
| Enumeration Date | 2023-06-22 |
| Last Update Date | 2023-08-22 |