| NPI | 1871124545 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IN 71010698A) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: VT 026.0123354) |
| Enumeration Date | 2020-01-30 |
| Last Update Date | 2021-02-10 |