| NPI | 1629616164 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: SD CP001690) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IA A158422) |
| 363LF0000X Nurse Practitioner, Family (Licence: NE 116321) | |
| Enumeration Date | 2019-12-16 |
| Last Update Date | 2025-09-26 |