| NPI | 1235860883 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IN 71012694A) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: IN 71012694A) |
| 363LP2300X Nurse Practitioner, Primary Care (Licence: IN 71012694A) | |
| Enumeration Date | 2022-06-23 |
| Last Update Date | 2025-02-14 |