NPI | 1003434317 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KY 3014609) |
Additional Taxonomies | 163WG0000X Registered Nurse, General Practice (Licence: KY 198028) |
Enumeration Date | 2020-07-13 |
Last Update Date | 2020-12-14 |