| NPI | 1205512910 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: SD CP003754) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MN 10607) |
| Enumeration Date | 2023-06-26 |
| Last Update Date | 2025-12-02 |