| NPI | 1104217595 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: DE LG-0000881) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: DE L1-0034550) |
| 363LF0000X Nurse Practitioner Family (Licence: DE LG-0000881) | |
| Enumeration Date | 2015-02-07 |
| Last Update Date | 2025-02-19 |