| 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 |