| NPI | 1528150919 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: SD R019554) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: SD CP000477) |
| Enumeration Date | 2006-09-29 |
| Last Update Date | 2013-02-06 |