NPI | 1245700442 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KY 3012947) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: KY 1139292) |
Enumeration Date | 2018-11-29 |
Last Update Date | 2023-06-28 |