| NPI | 1164064226 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: SD CP001645) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MN 7199) |
| Enumeration Date | 2019-10-10 |
| Last Update Date | 2022-03-30 |