| NPI | 1114413804 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IN 71008049A) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MI 4704364501) |
| Enumeration Date | 2018-07-05 |
| Last Update Date | 2020-08-11 |