| NPI | 1952790750 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: OK 118271) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: FL RN9285701) |
| Enumeration Date | 2015-01-15 |
| Last Update Date | 2015-08-11 |