NPI | 1265931851 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KY 3011776) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: KY F10170103) |
Enumeration Date | 2018-02-08 |
Last Update Date | 2023-01-09 |