| NPI | 1194206789 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: IN 71008416A)  | 
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: KY 3019089)  | 
| Enumeration Date | 2018-08-22 | 
| Last Update Date | 2024-02-13 |