| NPI | 1013263979 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: SD CP000730) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MN CNP4220) |
| Enumeration Date | 2012-07-30 |
| Last Update Date | 2022-06-14 |