| NPI | 1619049756 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MA 214532) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: VT 101-0022621) |
| Enumeration Date | 2006-11-14 |
| Last Update Date | 2012-11-08 |