| NPI | 1699117630 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: VT 101.0134639) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NY F340998-1) |
| Enumeration Date | 2013-07-18 |
| Last Update Date | 2021-02-11 |