| NPI | 1770147688 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: OK 118628) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: OK R0118628) |
| Enumeration Date | 2019-04-25 |
| Last Update Date | 2022-03-21 |