| NPI | 1972910602 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: IN 71005675A) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MO 2013011851) |
| Enumeration Date | 2014-07-15 |
| Last Update Date | 2020-07-16 |