| NPI | 1932403318 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: OK R35175) |
| Additional Taxonomies | 133N00000X Nutritionist (Licence: NA) |
| 163WL0100X Registered Nurse, Lactation Consultant (Licence: OK 10928150) | |
| Enumeration Date | 2010-12-29 |
| Last Update Date | 2014-06-04 |