NPI | 1619580081 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: VT 101.0134629) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: VT 1010134629) |
Enumeration Date | 2020-08-26 |
Last Update Date | 2022-09-12 |