| NPI | 1174222426 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: OK 214597) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: AZ 291192) |
| 363LF0000X Nurse Practitioner, Family (Licence: MT TBD) | |
| Enumeration Date | 2023-02-27 |
| Last Update Date | 2023-08-31 |