| NPI | 1508297599 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: VT 101.0134648) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NY F401672) |
| Enumeration Date | 2013-12-02 |
| Last Update Date | 2020-10-27 |