| NPI | 1194386029 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: OK 114923) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: OK 114923) |
| Enumeration Date | 2019-06-21 |
| Last Update Date | 2020-06-09 |