| NPI | 1912639295 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: VT 101.0135544) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: VT 026.0067184) |
| Enumeration Date | 2022-06-27 |
| Last Update Date | 2022-07-13 |