NPI | 1144619149 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KY 3009088) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MA RN2271909) |
Enumeration Date | 2015-01-13 |
Last Update Date | 2024-03-12 |