NPI | 1386739464 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: KY 34958) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: KY 3011631) |
Enumeration Date | 2006-10-04 |
Last Update Date | 2023-06-22 |