| NPI | 1528040805 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: IN 71002157A) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: IN 28068948) |
| 363LF0000X Nurse Practitioner, Family (Licence: IN 71002157) | |
| Enumeration Date | 2005-11-14 |
| Last Update Date | 2022-10-20 |