| NPI | 1396564894 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: OK 224062) | 
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: OK R0110416) | 
| Enumeration Date | 2024-10-10 | 
| Last Update Date | 2025-08-08 |