NPI | 1174282081 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KY 4001253) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: TN 30750) |
363LP2300X Nurse Practitioner, Primary Care (Licence: KY 4001253) | |
Enumeration Date | 2021-12-08 |
Last Update Date | 2024-02-05 |