| NPI | 1780053975 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: IN 28207609A) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MI 4704354652) |
| Enumeration Date | 2015-09-18 |
| Last Update Date | 2024-06-14 |