| NPI | 1962208678 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: SD CP003701) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MS 907212) |
| Enumeration Date | 2025-02-22 |
| Last Update Date | 2025-08-19 |