| NPI | 1730475120 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner Adult Health (Licence: IN 71003665A) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: IN 28183832A) |
| Enumeration Date | 2011-06-23 |
| Last Update Date | 2021-02-03 |