| NPI | 1720476484 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: OK 83615) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: OK R 0083615) |
| Enumeration Date | 2015-01-05 |
| Last Update Date | 2015-10-22 |