NPI | 1679534838 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NH 059920-23) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MA 246763) |
363LF0000X Nurse Practitioner, Family (Licence: VT 101-0042694) | |
Enumeration Date | 2006-03-29 |
Last Update Date | 2010-01-07 |