| NPI | 1346520368 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: SD CP000673) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: IA 106001) |
| 363LF0000X Nurse Practitioner, Family (Licence: IA A-106001) | |
| Enumeration Date | 2011-08-22 |
| Last Update Date | 2011-10-25 |