NPI | 1699711168 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: VT 1010030543) |
Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: MA RN2269517) |
Enumeration Date | 2006-06-21 |
Last Update Date | 2022-04-13 |