| NPI | 1356520431 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: VT 101-0043418) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: IA 112300) |
| Enumeration Date | 2007-10-25 |
| Last Update Date | 2017-01-13 |