| NPI | 1306362496 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: IN 71012359A) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: KY 3011625) |
| Enumeration Date | 2017-08-21 |
| Last Update Date | 2023-05-11 |