| NPI | 1487636288 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: VT 101-0023382) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: VT 101-0023382) |
| Enumeration Date | 2005-11-17 |
| Last Update Date | 2011-06-16 |