| NPI | 1578083861 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: IN 71007955A) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: KY 3011413) |
| Enumeration Date | 2017-06-27 |
| Last Update Date | 2020-12-03 |