| NPI | 1689195703 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: OK 205732) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024174916) |
| Enumeration Date | 2017-06-28 |
| Last Update Date | 2022-06-22 |