| NPI | 1407902968 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: SD R012514CNP0342) |
| Additional Taxonomies | 363LW0102X Nurse Practitioner, Women's Health (Licence: SD R012514CNP0342) |
| Enumeration Date | 2007-01-26 |
| Last Update Date | 2007-07-08 |