| NPI | 1104223007 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: PA SP016120) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: DE LG-0000797) |
| Enumeration Date | 2014-11-21 |
| Last Update Date | 2019-11-11 |