NPI | 1407230188 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KY 3011905) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: FL 9429002) |
363LF0000X Nurse Practitioner, Family (Licence: IL 209.012895) | |
Enumeration Date | 2015-07-13 |
Last Update Date | 2024-03-20 |