| NPI | 1629632229 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: OK 109418) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: OK R0109418) |
| Enumeration Date | 2019-04-29 |
| Last Update Date | 2022-03-01 |