NPI | 1609301894 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: KY 3018527) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: OH APRN.CNP.020720) |
363LF0000X Nurse Practitioner, Family (Licence: PA SP020410) | |
Enumeration Date | 2017-04-25 |
Last Update Date | 2023-04-04 |