| 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 |