| NPI | 1801284765 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024178600) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: DE L1-0039151) |
| 363L00000X Nurse Practitioner (Licence: DE LG-0000877) | |
| Enumeration Date | 2014-12-30 |
| Last Update Date | 2020-09-11 |