| NPI | 1902074677 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: NH 065844-23) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: MA 268247) |
| 363LA2200X Nurse Practitioner, Adult Health (Licence: VT 101.0061484) | |
| Enumeration Date | 2008-02-15 |
| Last Update Date | 2018-12-10 |