| NPI | 1568012961 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: VT 101.0134600) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MA RN2322196) |
| Enumeration Date | 2019-09-17 |
| Last Update Date | 2020-10-02 |