| NPI | 1366891095 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: OK 80868) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: OK R 0080868) |
| Enumeration Date | 2016-06-03 |
| Last Update Date | 2020-01-17 |