| NPI | 1265548861 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: VT 101.0092130) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: CO 75793) |
| 363LF0000X Nurse Practitioner, Family (Licence: RI CNNP37537) | |
| Enumeration Date | 2006-08-23 |
| Last Update Date | 2023-03-07 |