| NPI | 1821399957 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: DE C5-0012212) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: PA MA055005) |
| Enumeration Date | 2010-11-05 |
| Last Update Date | 2025-01-17 |