| NPI | 1750730966 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner Adult Health (Licence: SD CP001226) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner Adult Health (Licence: ND R32069) |
| Enumeration Date | 2016-06-08 |
| Last Update Date | 2018-01-02 |