| NPI | 1588177141 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NH 081771-23) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: PA SP018215) |
| 363L00000X Nurse Practitioner (Licence: VT 101.0134383) | |
| 363L00000X Nurse Practitioner (Licence: MA RN2337721) | |
| Enumeration Date | 2017-11-06 |
| Last Update Date | 2022-11-14 |