| NPI | 1487019659 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: OK R0041253) |
| Additional Taxonomies | 363LG0600X Nurse Practitioner, Gerontology (Licence: OK Roo41253) |
| 363LA2200X Nurse Practitioner, Adult Health (Licence: OK R0041253) | |
| Enumeration Date | 2015-12-15 |
| Last Update Date | 2018-05-07 |