| NPI | 1083205496 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: IN 71011109A) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: IN 000000000000) |
| 363L00000X Nurse Practitioner (Licence: OH APRN.CNP.0031428) | |
| Enumeration Date | 2021-01-28 |
| Last Update Date | 2022-06-14 |