| NPI | 1992038368 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: VT 1010122724) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NY f336014-1) |
| Enumeration Date | 2009-09-16 |
| Last Update Date | 2016-08-18 |