NPI | 1740807114 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: VT 101.0135068) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NH 071232-23) |
Enumeration Date | 2020-07-01 |
Last Update Date | 2024-01-30 |