| NPI | 1700092822 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171W00000X Contractor (Licence: VT 0260029480) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: VT 26.0029480) |
| 163WL0100X Registered Nurse, Lactation Consultant (Licence: VT 26.0029480) | |
| Enumeration Date | 2007-05-15 |
| Last Update Date | 2025-03-31 |