| NPI | 1346765146 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IN 71007581A) |
| Additional Taxonomies | 261QM2500X Clinic/Center, Medical Specialty (Licence: CT 12.012722) |
| 261QM2500X Clinic/Center, Medical Specialty (Licence: NY 353016) | |
| Enumeration Date | 2017-08-14 |
| Last Update Date | 2024-02-28 |