| NPI | 1083179394 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: OK 202201) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: NY 309039) |
| Enumeration Date | 2019-01-31 |
| Last Update Date | 2022-05-02 |