| NPI | 1861801565 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WI 14613-33) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: OK 100661) |
| 363LF0000X Nurse Practitioner, Family (Licence: OK 100661) | |
| Enumeration Date | 2014-08-06 |
| Last Update Date | 2024-05-09 |