| NPI | 1104191402 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: IN 71003910A) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: IN 28157102A) |
| Enumeration Date | 2012-03-20 |
| Last Update Date | 2020-12-15 |