| NPI | 1871919621 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MD R213056) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MD AC001310) |
| 363LF0000X Nurse Practitioner, Family (Licence: DE LG-0000736) | |
| Enumeration Date | 2014-03-17 |
| Last Update Date | 2014-11-18 |