| NPI | 1508496134 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: SD CP002634) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: IA H158042) |
| Enumeration Date | 2020-01-23 |
| Last Update Date | 2025-04-14 |