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 |