| NPI | 1205123700 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MD AC00147) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: DE LG0000775) |
| Enumeration Date | 2011-07-05 |
| Last Update Date | 2019-02-13 |