| NPI | 1295738789 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: SD CP000049) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: SD 0625) |
| Enumeration Date | 2005-05-27 |
| Last Update Date | 2009-11-03 |