| NPI | 1083133615 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IN 71007527A) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: VA 0024178189) |
| 363LF0000X Nurse Practitioner Family (Licence: IN 71007527A) | |
| 363LF0000X Nurse Practitioner Family (Licence: AZ 231371) | |
| Enumeration Date | 2017-09-14 |
| Last Update Date | 2021-08-04 |