NPI | 1508104258 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KY 3007898) |
Additional Taxonomies | 363LA2100X Nurse Practitioner, Acute Care (Licence: KY 3007898) |
363LF0000X Nurse Practitioner, Family (Licence: IN 71004367A) | |
Enumeration Date | 2013-01-30 |
Last Update Date | 2020-12-02 |