| NPI | 1700594066 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: VT 101.0135915PROV) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: VT 026.0034921) |
| Enumeration Date | 2022-11-07 |
| Last Update Date | 2023-01-04 |