| NPI | 1497647721 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: SD CP003724) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: SC 31672) |
| 207Q00000X Family Medicine (Licence: SD CP003724) | |
| Enumeration Date | 2025-07-21 |
| Last Update Date | 2026-04-20 |