| NPI | 1588120497 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MD R203726) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MD R203726) |
| 363LF0000X Nurse Practitioner, Family (Licence: DE LG-0001238) | |
| Enumeration Date | 2019-02-15 |
| Last Update Date | 2019-03-11 |