| NPI | 1144608605 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: IN 71005837A) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: KY 3011812) |
| Enumeration Date | 2015-05-15 |
| Last Update Date | 2020-07-10 |