| NPI | 1992715262 |
|---|---|
| Former Name | DIANNE PATRICIA DOUGLAS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: VT 1010011670) |
| Enumeration Date | 2006-08-09 |
| Last Update Date | 2007-07-08 |