| NPI | 1861422735 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner Psychiatric/Mental Health (Licence: VT 101-0016244) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner Adult Health (Licence: VT 101-0016244) |
| 363LP0200X Nurse Practitioner Pediatrics (Licence: VT 101-0016244) | |
| Enumeration Date | 2006-07-04 |
| Last Update Date | 2013-10-04 |