| NPI | 1275684292 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: WY 37079.1488) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IN 28096940A) |
| 363L00000X Nurse Practitioner (Licence: IN 71002348A) | |
| Enumeration Date | 2007-01-16 |
| Last Update Date | 2016-03-23 |