| NPI | 1619132677 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: OK 47205) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TX 530607) |
| Enumeration Date | 2008-07-18 |
| Last Update Date | 2015-05-26 |