NPI | 1376882225 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN11015650) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: KY 3008520) |
363LA2200X Nurse Practitioner, Adult Health (Licence: OH COA.14270-NP) | |
Enumeration Date | 2013-02-12 |
Last Update Date | 2023-01-18 |