NPI | 1609393578 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: KY 3011616) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: KY 3011616) |
Enumeration Date | 2017-08-23 |
Last Update Date | 2018-03-09 |