| NPI | 1265111082 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner Pediatrics (Licence: SD CP002887) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: SD CP002887) |
| Enumeration Date | 2023-07-18 |
| Last Update Date | 2023-12-05 |