| NPI | 1588058614 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: IN 71005535A) | 
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: IN 28185140A) | 
| Enumeration Date | 2015-03-26 | 
| Last Update Date | 2015-11-03 |