NPI | 1578240339 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KY 3019131) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: KY 1124674) |
Enumeration Date | 2023-07-03 |
Last Update Date | 2024-05-29 |