| NPI | 1417919960 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: SD CP00095) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NE 110503) |
| 363LF0000X Nurse Practitioner, Family (Licence: SD R016791) | |
| 363LN0000X Nurse Practitioner, Neonatal (Licence: MN R160584-4) | |
| Enumeration Date | 2006-04-03 |
| Last Update Date | 2012-01-31 |