| NPI | 1104336536 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: OK 113409) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MO 2020036159) |
| Enumeration Date | 2017-10-12 |
| Last Update Date | 2025-08-07 |