| NPI | 1689241820 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: VT 101.0134869) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: VT 026.0096030) |
| Enumeration Date | 2021-06-07 |
| Last Update Date | 2021-09-14 |