NPI | 1508422288 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: KY 3013147) |
Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: KY 3013147) |
363LG0600X Nurse Practitioner, Gerontology (Licence: KY 3013147) | |
Enumeration Date | 2019-05-17 |
Last Update Date | 2022-09-07 |