| NPI | 1376987610 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MD R125020) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: DE LG0000676) |
| Enumeration Date | 2013-04-17 |
| Last Update Date | 2013-05-01 |