| NPI | 1396169538 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: OK 93652) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: OK K2258689) |
| Enumeration Date | 2014-02-07 |
| Last Update Date | 2020-11-10 |