| NPI | 1417435462 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: SD CP001429) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: IA 132174) |
| 363LF0000X Nurse Practitioner, Family (Licence: IA A132174) | |
| Enumeration Date | 2018-08-01 |
| Last Update Date | 2018-08-31 |