NPI | 1265260061 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KY 4022839) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: KY 4022839) |
363LP0222X Nurse Practitioner, Pediatrics, Critical Care (Licence: KY 4022839) | |
Enumeration Date | 2024-07-23 |
Last Update Date | 2024-07-23 |