| NPI | 1821048646 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: VT 1010016189) | 
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: FL ARNP 9335078) | 
| Enumeration Date | 2006-05-11 | 
| Last Update Date | 2012-09-24 |