NPI | 1417601444 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KY 3016875) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: KY 1154982) |
Enumeration Date | 2022-02-08 |
Last Update Date | 2022-02-08 |