| NPI | 1093221871 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: SD CP001333) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: SD R040117) |
| 363LF0000X Nurse Practitioner Family (Licence: SD CP001333) | |
| Enumeration Date | 2017-12-16 |
| Last Update Date | 2022-04-18 |