| NPI | 1639439110 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: SD CP000709) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: SD CP000709) |
| Enumeration Date | 2012-05-18 |
| Last Update Date | 2021-02-01 |