| NPI | 1104595834 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: DE LP-0010453) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: DE L1-0052533) |
| Enumeration Date | 2021-09-07 |
| Last Update Date | 2021-09-07 |