| NPI | 1104325992 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IN 71007854A) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: IN 28173103A) |
| Enumeration Date | 2018-02-07 |
| Last Update Date | 2018-03-23 |