| NPI | 1790772358 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: IN 28105262) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: IN 71000181) |
| Enumeration Date | 2005-09-29 |
| Last Update Date | 2007-07-08 |