| NPI | 1073774279 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: OK 77451) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: GA 174976) |
| Enumeration Date | 2008-06-19 |
| Last Update Date | 2011-10-26 |