| NPI | 1386017689 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL ARNP9465865) | 
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: FL ARNP9465865) | 
| 363L00000X Nurse Practitioner (Licence: PA RN620968) | |
| 363LA2100X Nurse Practitioner, Acute Care (Licence: PA SP015616) | |
| 363LP2300X Nurse Practitioner, Primary Care (Licence: FL ARNP9465865) | |
| Enumeration Date | 2015-11-09 | 
| Last Update Date | 2019-02-28 |