| NPI | 1902940745 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: IN 71002357A) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: IN 28087567A) |
| Enumeration Date | 2007-02-16 |
| Last Update Date | 2011-06-29 |