NPI | 1083308134 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KY 4005342) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: KY 15942250) |
Enumeration Date | 2023-06-02 |
Last Update Date | 2024-02-06 |