| NPI | 1114193786 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IN 71002633A)  | 
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: FL 9448019)  | 
| Enumeration Date | 2008-05-05 | 
| Last Update Date | 2019-06-04 |