| NPI | 1811164593 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IN 71004261A) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TN APN0000013442) |
| Enumeration Date | 2008-05-13 |
| Last Update Date | 2013-01-02 |