| NPI | 1962902254 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: IN 28167297A) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: IN 28167297A) |
| Enumeration Date | 2018-02-13 |
| Last Update Date | 2019-03-08 |