| NPI | 1033711544 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: SD CP001879) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner Pediatrics (Licence: SD CP001879) |
| Enumeration Date | 2020-11-10 |
| Last Update Date | 2021-02-05 |