| NPI | 1609888684 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: VT 1010101436) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: WA AP60303523) |
| 363L00000X Nurse Practitioner (Licence: WI 1813) | |
| Enumeration Date | 2006-08-11 |
| Last Update Date | 2014-10-02 |