NPI | 1558753871 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: VT 101.0109873) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: VT 1010109873) |
Enumeration Date | 2015-02-24 |
Last Update Date | 2025-08-08 |