| NPI | 1386735793 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: DE L10011579) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: DE L1-0011579) |
| 363LP0200X Nurse Practitioner, Pediatrics (Licence: DE L10011579) | |
| Enumeration Date | 2006-09-28 |
| Last Update Date | 2018-06-06 |