| NPI | 1104139195 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: IN 71003250A) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: IN 28149261A) |
| Enumeration Date | 2010-07-19 |
| Last Update Date | 2017-03-23 |