| NPI | 1275919540 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MD R236410)  | 
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: PA SP015170)  | 
| 363LF0000X Nurse Practitioner, Family (Licence: DE LG-0011802)  | |
| Enumeration Date | 2015-08-10 | 
| Last Update Date | 2024-04-30 |