| NPI | 1912341306 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: VT 101.00113985) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: NY 33 337930) |
| Enumeration Date | 2013-04-29 |
| Last Update Date | 2015-08-25 |