| NPI | 1518271394 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: SD R029889) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: SD CP000600) |
| Enumeration Date | 2010-08-04 |
| Last Update Date | 2013-02-05 |