| NPI | 1912510306 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: IN 3014411) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: KY 3014411) |
| Enumeration Date | 2020-08-26 |
| Last Update Date | 2021-11-01 |