| NPI | 1861035958 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: OK 116672) |
| Additional Taxonomies | 163WP0200X Registered Nurse, Pediatrics (Licence: OK 116672) |
| Enumeration Date | 2019-10-22 |
| Last Update Date | 2021-08-12 |