| NPI | 1346261054 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: VT 1010017766) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NY F3335321) |
| Enumeration Date | 2006-07-21 |
| Last Update Date | 2007-07-08 |