| NPI | 1215234752 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner Primary Care (Licence: IN 71003550A) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner Adult Health (Licence: IN 28075275A) |
| Enumeration Date | 2011-02-18 |
| Last Update Date | 2022-07-18 |