| NPI | 1205601416 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: IN 71014606A) |
| Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: IN 28211427C) |
| Enumeration Date | 2023-11-17 |
| Last Update Date | 2026-08-11 |