NPI | 1508578352 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KY 3018806) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: KY 3018806) |
Enumeration Date | 2022-12-22 |
Last Update Date | 2023-05-18 |