| NPI | 1265604557 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NM 72100) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: OK 90898) |
| 363LF0000X Nurse Practitioner, Family (Licence: MT 161890) | |
| Enumeration Date | 2008-03-27 |
| Last Update Date | 2023-05-09 |