| NPI | 1376542001 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: MT 101017) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: DE LG-0000339) |
| 363LF0000X Nurse Practitioner Family (Licence: MA 271323) | |
| Enumeration Date | 2005-07-15 |
| Last Update Date | 2018-04-27 |