NPI | 1174144679 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KY 3016964) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: KY 1158959) |
Enumeration Date | 2020-05-06 |
Last Update Date | 2024-12-12 |