| NPI | 1942718358 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: OK 2021001219) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: OK AG1217004) |
| Enumeration Date | 2018-01-19 |
| Last Update Date | 2021-10-05 |