| NPI | 1447841077 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: SD CP002159) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: SD R037443) |
| Enumeration Date | 2021-01-27 |
| Last Update Date | 2022-04-29 |