| NPI | 1790228070 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: OK 78791) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: OK R0078791) |
| Enumeration Date | 2016-11-18 |
| Last Update Date | 2017-01-12 |