| NPI | 1154789576 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: OK 96847) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: OK 96847) |
| Enumeration Date | 2016-01-29 |
| Last Update Date | 2019-08-26 |