| NPI | 1275949455 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MD R173173)  | 
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MD R173173)  | 
| 363L00000X Nurse Practitioner (Licence: DE LG-0000761)  | |
| 363LF0000X Nurse Practitioner, Family (Licence: DE LG-0000761)  | |
| Enumeration Date | 2014-07-08 | 
| Last Update Date | 2018-07-31 |