| NPI | 1639587660 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: VT 101-0105795) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: VT 026.0104428) |
| Enumeration Date | 2014-07-22 |
| Last Update Date | 2019-03-27 |