| NPI | 1528320470 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: SD CP001341) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: WV 82833) |
| Enumeration Date | 2012-06-15 |
| Last Update Date | 2020-08-05 |