| NPI | 1083678890 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: DE L1-0024916) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: PA UP003645O) |
| 363L00000X Nurse Practitioner (Licence: PA UP0036450) | |
| Enumeration Date | 2006-04-17 |
| Last Update Date | 2013-01-04 |