| NPI | 1053988246 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IN 71012268A)  | 
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: IL 209.022808)  | 
| 363LF0000X Nurse Practitioner, Family (Licence: IN 28271741A)  | |
| 363L00000X Nurse Practitioner (Licence: NY F346395-01)  | |
| Enumeration Date | 2021-06-07 | 
| Last Update Date | 2023-09-14 |