| NPI | 1255713665 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NM 57292) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: OK 116684) |
| Enumeration Date | 2015-06-22 |
| Last Update Date | 2019-09-12 |