| NPI | 1821334913 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: SD CP000780) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: SD R036344) |
| Enumeration Date | 2012-12-18 |
| Last Update Date | 2013-11-13 |