NPI | 1346398187 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KY 5064P) |
Additional Taxonomies | 163WR0006X Registered Nurse, Registered Nurse First Assistant (Licence: KY 1033354) |
Enumeration Date | 2007-01-08 |
Last Update Date | 2012-01-18 |