| NPI | 1619538469 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: OK 109568) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: OK 109568) |
| Enumeration Date | 2019-06-24 |
| Last Update Date | 2020-05-12 |