NPI | 1659057131 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: VT 101.0136325) |
Additional Taxonomies | 363LP2300X Nurse Practitioner, Primary Care (Licence: VT 101.0136325) |
Enumeration Date | 2023-06-27 |
Last Update Date | 2023-06-27 |