NPI | 1467025619 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KY 3016693) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: FL 11013751) |
Enumeration Date | 2021-07-23 |
Last Update Date | 2024-07-30 |