| NPI | 1669692158 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MO 2012035664) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: SD SD-RN R034321) |
| 363LF0000X Nurse Practitioner, Family (Licence: SD SD-CNP CP000610) | |
| 163W00000X Registered Nurse (Licence: MO 2004008434) | |
| Enumeration Date | 2007-04-26 |
| Last Update Date | 2016-05-13 |