| NPI | 1801842174 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: SD CP000113) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: IA 073137) |
| 363L00000X Nurse Practitioner (Licence: SD R024346) | |
| Enumeration Date | 2006-05-26 |
| Last Update Date | 2022-03-30 |