| NPI | 1639501844 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: SD SD-CNP CP000804) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: WY 1381) |
| Enumeration Date | 2013-07-30 |
| Last Update Date | 2025-12-01 |