| NPI | 1578763447 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IN 71003782) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: IN 28126804A) |
| 163W00000X Registered Nurse (Licence: IL 041-307615) | |
| Enumeration Date | 2007-07-19 |
| Last Update Date | 2011-11-21 |