| NPI | 1982614491 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: VT 101-0019495) | 
| Additional Taxonomies | 363LP2300X Nurse Practitioner, Primary Care (Licence: VT 101-0019495) | 
| 363LW0102X Nurse Practitioner, Women's Health (Licence: VT 101-0019495) | |
| Enumeration Date | 2006-08-08 | 
| Last Update Date | 2014-04-07 |