NPI | 1538632609 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KY 3013015) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: KY 3013015) |
Enumeration Date | 2019-01-10 |
Last Update Date | 2022-05-10 |