NPI | 1205427044 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KY 3015793) |
Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: KY 3015793) |
363LF0000X Nurse Practitioner, Family (Licence: IN 71014235A) | |
Enumeration Date | 2021-02-02 |
Last Update Date | 2023-11-08 |