| NPI | 1912303058 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: OK 77842) |
| Additional Taxonomies | 163WE0003X Registered Nurse Emergency (Licence: OK 77842) |
| 224900000X Mastectomy Fitter | |
| Enumeration Date | 2014-11-18 |
| Last Update Date | 2020-02-28 |