| 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 |