| NPI | 1760912208 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: SD CP001197) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: SD R040266) |
| Enumeration Date | 2017-06-18 |
| Last Update Date | 2020-05-05 |