| NPI | 1063819993 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IN 71005423A)  | 
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: IN 28098686A)  | 
| 363LA2200X Nurse Practitioner, Adult Health (Licence: IN 71005423A)  | |
| Enumeration Date | 2014-11-20 | 
| Last Update Date | 2021-05-07 |