| NPI | 1952759904 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: VT 101.0119556) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NH 034630-23) |
| Enumeration Date | 2016-06-01 |
| Last Update Date | 2021-03-09 |