| NPI | 1750563169 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IN 71004935B) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NC 097054) |
| Enumeration Date | 2007-11-28 |
| Last Update Date | 2022-07-21 |