| NPI | 1770504516 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: VT 101.0021053) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: VT 101-0021053) |
| 363LF0000X Nurse Practitioner, Family (Licence: VT 101.0021053) | |
| Enumeration Date | 2006-07-21 |
| Last Update Date | 2014-12-04 |