| NPI | 1568711786 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NE 114106) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: SD CP000855) |
| 363LF0000X Nurse Practitioner, Family (Licence: IA A106233) | |
| Enumeration Date | 2012-09-04 |
| Last Update Date | 2022-05-23 |