| NPI | 1770948150 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: SD CP001031) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: SD R040210) |
| Enumeration Date | 2015-12-29 |
| Last Update Date | 2016-02-04 |