| NPI | 1356608103 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: OK RN0081023) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: OK R81023) |
| 363LF0000X Nurse Practitioner, Family (Licence: OK K2009687) | |
| Enumeration Date | 2012-04-18 |
| Last Update Date | 2020-01-16 |