| NPI | 1245871466 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: SD CP001649) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: SD CP001649) |
| Enumeration Date | 2019-09-30 |
| Last Update Date | 2024-12-05 |