| NPI | 1477589497 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: SD CP002090) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: WI 169519) |
| Enumeration Date | 2006-06-23 |
| Last Update Date | 2021-08-26 |