NPI | 1396520839 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KY 4009279) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: KY 4009279) |
Enumeration Date | 2023-08-30 |
Last Update Date | 2025-01-28 |