| NPI | 1679703227 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IN 71014816A) |
| Additional Taxonomies | 363LA2100X Nurse Practitioner, Acute Care (Licence: TN 17570) |
| 363LA2100X Nurse Practitioner, Acute Care (Licence: IN 71014816A) | |
| 363LF0000X Nurse Practitioner, Family (Licence: VA 0024188690) | |
| Enumeration Date | 2009-07-16 |
| Last Update Date | 2024-01-02 |