| NPI | 1699767640 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IN 71001371) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: IN 71001371A) |
| Enumeration Date | 2005-08-16 |
| Last Update Date | 2007-07-08 |