| NPI | 1881133122 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: SD CP001190) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: SD R039772) |
| Enumeration Date | 2017-02-20 |
| Last Update Date | 2018-11-29 |