| NPI | 1205167566 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IN 71007230a) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: FL RN) |
| 363L00000X Nurse Practitioner (Licence: MO 2011002627) | |
| 363LF0000X Nurse Practitioner, Family (Licence: FL 9202508) | |
| Enumeration Date | 2010-01-26 |
| Last Update Date | 2020-04-13 |