| NPI | 1306515739 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner Primary Care (Licence: SD CP002138) |
| Additional Taxonomies | 163WP2201X Registered Nurse Ambulatory Care (Licence: SD R041376) |
| Enumeration Date | 2021-09-09 |
| Last Update Date | 2021-09-10 |