| NPI | 1114464575 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: IN 71007760A) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: IN 28191010A) |
| 363LG0600X Nurse Practitioner, Gerontology (Licence: IN 71007760A) | |
| Enumeration Date | 2017-01-24 |
| Last Update Date | 2018-08-02 |