| NPI | 1023797750 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: SD CP003082)  | 
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: SD R046334)  | 
| Enumeration Date | 2023-07-11 | 
| Last Update Date | 2024-02-03 |