| NPI | 1396612115 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2100X Nurse Practitioner, Acute Care (Licence: IN 71017157A) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: IN 28225063A) |
| Enumeration Date | 2025-10-17 |
| Last Update Date | 2025-11-06 |