| NPI | 1043648470 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NC 5012134) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: DE LG-0000830) |
| 363LF0000X Nurse Practitioner, Family (Licence: PA SP013265) | |
| Enumeration Date | 2013-10-22 |
| Last Update Date | 2019-08-16 |