| NPI | 1972883486 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: SD CP000668) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: SD R034742) |
| Enumeration Date | 2011-08-29 |
| Last Update Date | 2012-03-13 |