| NPI | 1710548706 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: IN 71009799A) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IL 041.403144) |
| Enumeration Date | 2019-06-21 |
| Last Update Date | 2020-09-18 |