| NPI | 1700442688 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: OK 205123) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MO 2019015942) |
| Enumeration Date | 2019-05-15 |
| Last Update Date | 2021-11-10 |