| NPI | 1609229707 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: VT 101-0134266) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 702951) |
| Enumeration Date | 2016-07-13 |
| Last Update Date | 2019-07-17 |