| NPI | 1083071906 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: OK 89088) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: OK 0089088) |
| Enumeration Date | 2016-01-22 |
| Last Update Date | 2020-01-24 |