| NPI | 1700867058 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: IN 71001654A) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: IN 28156667A) |
| Enumeration Date | 2005-11-11 |
| Last Update Date | 2019-05-01 |