| NPI | 1760786073 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NY 346244) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: OK 79209) |
| 363LF0000X Nurse Practitioner, Family (Licence: OK 79209) | |
| Enumeration Date | 2010-12-29 |
| Last Update Date | 2022-12-20 |