| NPI | 1992769764 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: SD CP000528) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IA A-006174) |
| Enumeration Date | 2006-04-17 |
| Last Update Date | 2008-04-11 |