NPI | 1376830281 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: VT 101-0134327) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MA RN2262711) |
Enumeration Date | 2011-06-30 |
Last Update Date | 2019-07-08 |