| NPI | 1336612662 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: OK 80049) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: OK 80049) |
| Enumeration Date | 2019-01-09 |
| Last Update Date | 2019-02-08 |