| NPI | 1649670316 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: SD CP001420) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MN R1983472) |
| Enumeration Date | 2014-08-29 |
| Last Update Date | 2022-03-30 |