| NPI | 1114179397 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IN 71002749A) | 
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IN 71002749) | 
| Enumeration Date | 2008-10-19 | 
| Last Update Date | 2021-02-01 |