| NPI | 1376251975 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NY 310703) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: VT 101.0135714) |
| 363L00000X Nurse Practitioner (Licence: MA RN2368897) | |
| Enumeration Date | 2022-11-11 |
| Last Update Date | 2022-11-11 |