NPI | 1972876191 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: OK 96559) |
Additional Taxonomies | 363LP2300X Nurse Practitioner, Primary Care (Licence: OK 96559) |
363LF0000X Nurse Practitioner, Family (Licence: TX 820817) | |
Enumeration Date | 2012-02-18 |
Last Update Date | 2019-01-15 |