| NPI | 1982178539 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IN 71008996A) |
| Additional Taxonomies | 163WG0000X Registered Nurse, General Practice (Licence: IN 28224142A) |
| Enumeration Date | 2019-01-16 |
| Last Update Date | 2020-12-07 |