NPI | 1043744063 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: KY 3014028) |
Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: OH APRN.CNP.020787) |
Enumeration Date | 2017-04-17 |
Last Update Date | 2021-11-18 |