| NPI | 1235307463 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: DE LG0000105) | 
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: DE L10015578) | 
| Enumeration Date | 2008-02-11 | 
| Last Update Date | 2011-09-27 |