| NPI | 1962874149 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: SD CP000992) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NE 111925) |
| Enumeration Date | 2015-10-27 |
| Last Update Date | 2021-04-22 |