| NPI | 1770538423 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: SD R016329) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MN 1583762) |
| Enumeration Date | 2006-05-23 |
| Last Update Date | 2011-12-22 |