| NPI | 1700375052 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL 9402632)  | 
| Additional Taxonomies | 163WG0000X Registered Nurse, General Practice (Licence: FL 9402632)  | 
| 363L00000X Nurse Practitioner (Licence: FL ARNP9402632)  | |
| 363LP2300X Nurse Practitioner, Primary Care (Licence: FL ARNP9402632)  | |
| Enumeration Date | 2018-05-02 | 
| Last Update Date | 2019-05-01 |