| NPI | 1255800926 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: OK R0082768) | 
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: OK 82768) | 
| Enumeration Date | 2018-11-25 | 
| Last Update Date | 2020-01-22 |