| NPI | 1356951669 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: VT 101.0134625) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: VT 026.0050499) |
| Enumeration Date | 2020-08-03 |
| Last Update Date | 2020-11-15 |