| NPI | 1720317886 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: WY 44150) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: SD CP001061) |
| 163W00000X Registered Nurse (Licence: SD R034518) | |
| Enumeration Date | 2009-12-18 |
| Last Update Date | 2020-11-10 |