| 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 |