NPI | 1124494984 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KY 3010293) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IN 71005697A) |
Enumeration Date | 2015-08-17 |
Last Update Date | 2023-08-23 |