| NPI | 1649344227 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: IN 71002721A) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MI 4704155800) |
| Enumeration Date | 2006-11-17 |
| Last Update Date | 2012-07-23 |