| NPI | 1104632199 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: IN 28123772A) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: IN 71016113A) |
| Enumeration Date | 2024-12-05 |
| Last Update Date | 2025-07-10 |