| NPI | 1609804061 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: DE LB-0000236) | 
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: PA sp003309c) | 
| Enumeration Date | 2006-06-28 | 
| Last Update Date | 2011-10-17 |