| NPI | 1083174874 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IN 71010983A) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TX AP139421) |
| Enumeration Date | 2019-03-20 |
| Last Update Date | 2021-04-05 |