| NPI | 1720747355 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: UT 13077780-4405) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: OK 205777) |
| 363LF0000X Nurse Practitioner, Family (Licence: OK 205777) | |
| Enumeration Date | 2021-12-10 |
| Last Update Date | 2025-11-11 |