NPI | 1396717609 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KY 3003397) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NC 5006642) |
Enumeration Date | 2006-02-02 |
Last Update Date | 2014-12-10 |