| NPI | 1255848263 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: IN 71007769A) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: IN 28177745A) |
| 363LP2300X Nurse Practitioner, Primary Care (Licence: IN 71007769A) | |
| Enumeration Date | 2017-12-29 |
| Last Update Date | 2021-04-09 |