| NPI | 1407395759 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: DE LP-0000189) |
| Additional Taxonomies | 363LP2300X Nurse Practitioner, Primary Care (Licence: PA SP-017144) |
| Enumeration Date | 2017-02-20 |
| Last Update Date | 2017-03-28 |