| NPI | 1265705743 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: IN 71003974A) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: IN 28137260A) |
| Enumeration Date | 2012-02-15 |
| Last Update Date | 2021-09-08 |