| NPI | 1760034920 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: IN 71009244A) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: IN 28202584A) |
| 363L00000X Nurse Practitioner (Licence: KY 301376) | |
| Enumeration Date | 2019-07-09 |
| Last Update Date | 2019-09-23 |