| NPI | 1053771535 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: IN 71006397A) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IN 28140568A) |
| Enumeration Date | 2016-02-26 |
| Last Update Date | 2016-07-19 |