| NPI | 1154861276 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: OK R0134145) | 
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MO 2017002508) | 
| Enumeration Date | 2017-03-08 | 
| Last Update Date | 2019-10-16 |