| NPI | 1619134715 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: DE LG0000191) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: DE LI0016126) |
| Enumeration Date | 2008-05-18 |
| Last Update Date | 2008-05-18 |