| NPI | 1962894519 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: OK 103776) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: OK 103776) |
| Enumeration Date | 2015-02-19 |
| Last Update Date | 2018-03-17 |