| NPI | 1457722480 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner Primary Care (Licence: VT 101.0134209) |
| Additional Taxonomies | 363LP2300X Nurse Practitioner Primary Care (Licence: PA SP015453) |
| Enumeration Date | 2015-10-16 |
| Last Update Date | 2018-10-10 |