| NPI | 1043760424 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: IN 71009266A) | 
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: WA AP60670633) | 
| 363LF0000X Nurse Practitioner, Family (Licence: NC 5009010) | |
| Enumeration Date | 2016-10-10 | 
| Last Update Date | 2019-09-27 |