| NPI | 1578174975 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: SD CP001947) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IA A160029) |
| Enumeration Date | 2020-08-11 |
| Last Update Date | 2021-01-19 |