| NPI | 1851816961 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NY F342170-1) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: VT 101.0134315) |
| Enumeration Date | 2017-08-09 |
| Last Update Date | 2020-09-10 |