| NPI | 1861965089 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: SD CP002478) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: IA A152481) |
| 363LF0000X Nurse Practitioner, Family (Licence: IA A152481) | |
| Enumeration Date | 2019-01-10 |
| Last Update Date | 2025-11-17 |