| NPI | 1104308089 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IN 71008502A) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: IN 28141704A) |
| Enumeration Date | 2018-09-06 |
| Last Update Date | 2019-06-17 |