NPI | 1023644226 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KY 4012861) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: KY 1089526) |
Enumeration Date | 2020-03-19 |
Last Update Date | 2025-02-18 |