| NPI | 1376158295 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: OK 94920) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TX 1008682) |
| Enumeration Date | 2020-09-09 |
| Last Update Date | 2022-02-18 |