| NPI | 1962118398 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: OK 211638) |
| Additional Taxonomies | 261QU0200X Clinic/Center, Urgent Care (Licence: OK 211638) |
| Enumeration Date | 2023-01-30 |
| Last Update Date | 2025-01-03 |