| NPI | 1790253953 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: SD CP001495) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: SD R024746) |
| Enumeration Date | 2018-11-06 |
| Last Update Date | 2018-11-06 |