| NPI | 1164734646 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: SD CP000594) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: SD R033758) |
| Enumeration Date | 2010-07-13 |
| Last Update Date | 2020-10-07 |