| NPI | 1720756679 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: SD CP002120) |
| Additional Taxonomies | 363LC1500X Nurse Practitioner Community Health (Licence: SD CP002120) |
| Enumeration Date | 2021-09-03 |
| Last Update Date | 2022-05-04 |