NPI | 1215632559 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KY 4005316) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: WV 115910) |
363LF0000X Nurse Practitioner, Family (Licence: OH APRN.CNP.0033570) | |
Enumeration Date | 2023-04-04 |
Last Update Date | 2023-08-03 |