| NPI | 1336658194 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN11044331) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: VT 101.0138622TELE) |
| 363LF0000X Nurse Practitioner, Family (Licence: IA A188601) | |
| 363LF0000X Nurse Practitioner, Family (Licence: CT 16475) | |
| 363LF0000X Nurse Practitioner, Family (Licence: TN 40745) | |
| 363LF0000X Nurse Practitioner, Family (Licence: NY 358474) | |
| Enumeration Date | 2017-09-25 |
| Last Update Date | 2026-02-02 |