| NPI | 1699056069 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: SD CP000647) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IA R035284) |
| Enumeration Date | 2011-08-30 |
| Last Update Date | 2018-06-12 |