NPI | 1598304040 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KY 3014192) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: KY 1138273) |
Enumeration Date | 2020-01-02 |
Last Update Date | 2021-04-09 |