| NPI | 1659604536 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: KY 3009057) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: OK 66498) |
| Enumeration Date | 2009-09-10 |
| Last Update Date | 2014-11-11 |