| NPI | 1407348675 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: VT 101-0134517) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: SC 21807) |
| Enumeration Date | 2018-06-04 |
| Last Update Date | 2023-07-05 |