| NPI | 1942850862 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: SD CP001748) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MN 2477350) |
| Enumeration Date | 2019-09-12 |
| Last Update Date | 2020-05-22 |