| NPI | 1083928303 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: OK R0062209) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: OK 20101919) |
| 363LP2300X Nurse Practitioner, Primary Care (Licence: OK 20101919) | |
| Enumeration Date | 2010-07-28 |
| Last Update Date | 2011-03-24 |