| NPI | 1003362658 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: OK 96474) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: OK 96474) |
| Enumeration Date | 2016-09-01 |
| Last Update Date | 2016-09-30 |