| NPI | 1790168516 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: IN 71005613A) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: KY 3012493) |
| 363LF0000X Nurse Practitioner, Family (Licence: IN 28215502A) | |
| Enumeration Date | 2015-06-30 |
| Last Update Date | 2018-10-03 |