| NPI | 1174878995 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: OK 96224) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: UT 8949460-4405) |
| Enumeration Date | 2012-07-18 |
| Last Update Date | 2015-05-05 |