NPI | 1326551029 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KY 3013718) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: WV APRN76318-NP-C) |
Enumeration Date | 2017-11-16 |
Last Update Date | 2021-05-08 |