| NPI | 1184280166 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IN 71015466A) |
| Additional Taxonomies | 163WG0000X Registered Nurse, General Practice (Licence: IN 28250193A) |
| Enumeration Date | 2019-05-14 |
| Last Update Date | 2024-11-06 |