| NPI | 1639641202 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: OK 85964) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: OK 85964) |
| Enumeration Date | 2018-12-20 |
| Last Update Date | 2019-04-03 |