| NPI | 1588851216 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NC 5012665) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: IN 71000292A) |
| 363LP0200X Nurse Practitioner, Pediatrics (Licence: IN 28108473A) | |
| Enumeration Date | 2007-09-26 |
| Last Update Date | 2020-01-08 |