| NPI | 1255768966 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IN 71005047A) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IL 209010671) |
| Enumeration Date | 2013-09-26 |
| Last Update Date | 2016-06-30 |