| NPI | 1235778507 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: SD CP001698) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MN 8519) |
| Enumeration Date | 2020-01-03 |
| Last Update Date | 2022-04-09 |