| NPI | 1801869748 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: VT 101.0022960) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MA 216464) |
| Enumeration Date | 2006-02-10 |
| Last Update Date | 2014-07-28 |