| NPI | 1750971792 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IN 71010908A) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IL 209.022623) |
| Enumeration Date | 2021-01-23 |
| Last Update Date | 2021-03-24 |