| NPI | 1538585823 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: IN 71005004A) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: IN 28190142A) |
| Enumeration Date | 2014-03-11 |
| Last Update Date | 2015-02-23 |