| NPI | 1548627375 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: SD CP001030) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IA A154622) |
| Enumeration Date | 2016-01-25 |
| Last Update Date | 2019-09-09 |