| NPI | 1710396718 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: OK 210652) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: GA RN213432) |
| 363L00000X Nurse Practitioner (Licence: TX 1067064) | |
| 363LF0000X Nurse Practitioner, Family (Licence: GA RN213432) | |
| 363LF0000X Nurse Practitioner, Family (Licence: TX 1067064) | |
| Enumeration Date | 2014-08-05 |
| Last Update Date | 2023-03-21 |