| NPI | 1962236125 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: OK 221283) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MS 906911) |
| Enumeration Date | 2024-08-29 |
| Last Update Date | 2025-10-15 |