| NPI | 1669966180 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IN 71008741A)  | 
| Additional Taxonomies | 163WH0200X Registered Nurse, Home Health (Licence: IN 28194732A)  | 
| Enumeration Date | 2018-06-18 | 
| Last Update Date | 2022-01-17 |