| NPI | 1891203980 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: OK 82067) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: OH 022888) |
| Enumeration Date | 2018-01-11 |
| Last Update Date | 2019-11-13 |