| NPI | 1790035459 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: DE LB-0000271) | 
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: DE LB0000271) | 
| 163W00000X Registered Nurse (Licence: DE L1-0033254) | |
| Enumeration Date | 2012-09-10 | 
| Last Update Date | 2021-03-26 |