| NPI | 1720551674 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: OK 220103) | 
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: OK 117483) | 
| Enumeration Date | 2019-01-03 | 
| Last Update Date | 2025-02-07 |