| NPI | 1386698793 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LA2100X Nurse Practitioner Acute Care (Licence: VT 1010032233) |
| Additional Taxonomies | 261QU0200X Clinic/Center Urgent Care (Licence: VT 101-0032233) |
| Enumeration Date | 2006-05-20 |
| Last Update Date | 2013-10-04 |