| NPI | 1790322345 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: DE LG-0011487) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: NJ 26NJ00989900) |
| Enumeration Date | 2019-12-03 |
| Last Update Date | 2021-05-13 |