NPI | 1255821807 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KY 3012321) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: KY 3012321) |
Enumeration Date | 2018-05-18 |
Last Update Date | 2023-03-10 |