NPI | 1497130017 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN11030618) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: KY 3009442) |
Enumeration Date | 2015-07-24 |
Last Update Date | 2024-02-09 |