| NPI | 1295186203 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: MO 2016021963) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: OK 78872) |
| 363LA2200X Nurse Practitioner, Adult Health (Licence: OK 78872) | |
| Enumeration Date | 2016-06-30 |
| Last Update Date | 2021-10-25 |