| NPI | 1558607465 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: IN 71004313A) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: IN 28090698A) |
| Enumeration Date | 2012-12-20 |
| Last Update Date | 2021-03-25 |