| NPI | 1629016480 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: SD R018558) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: SD 0204) |
| Enumeration Date | 2006-06-03 |
| Last Update Date | 2013-01-24 |