| NPI | 1598273542 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: SD CP001601) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NE 112391) |
| Enumeration Date | 2018-01-11 |
| Last Update Date | 2019-07-11 |