| NPI | 1063980696 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: OK 109458) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TX 138713) |
| Enumeration Date | 2018-11-13 |
| Last Update Date | 2026-02-11 |