| NPI | 1407295090 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: DE L10040239) | 
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: DE LJ0000283) | 
| Enumeration Date | 2013-06-18 | 
| Last Update Date | 2013-06-18 |