| NPI | 1063771962 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: IN 71004088A) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: IN 28160871A) |
| 363LF0000X Nurse Practitioner, Family (Licence: IN 71004088A) | |
| Enumeration Date | 2012-05-11 |
| Last Update Date | 2019-07-02 |