| NPI | 1841869740 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: IN 71011404A) |
| Additional Taxonomies | 163WD0400X Registered Nurse, Diabetes Educator (Licence: IN 71011404A) |
| 363L00000X Nurse Practitioner (Licence: IN 28160468A) | |
| Enumeration Date | 2021-06-23 |
| Last Update Date | 2024-01-12 |