| NPI | 1649523515 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IN 71004262A) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IN 28173025A) |
| Enumeration Date | 2012-10-17 |
| Last Update Date | 2014-12-17 |