| NPI | 1790962843 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: KS 46159) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: OK 103110) |
| Enumeration Date | 2008-01-30 |
| Last Update Date | 2018-11-26 |