| NPI | 1326595240 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MA RN2291261) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: VT 101.0123649) |
| Enumeration Date | 2016-09-08 |
| Last Update Date | 2018-08-02 |