| NPI | 1063807121 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IN 71007451A) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: VT 101.0107424) |
| Enumeration Date | 2015-04-05 |
| Last Update Date | 2021-01-12 |