NPI | 1770859621 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: VT 101.0098916) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: VT 026.0028499) |
363LF0000X Nurse Practitioner, Family (Licence: NH 087144-23) | |
Enumeration Date | 2012-03-26 |
Last Update Date | 2022-01-18 |