NPI | 1609548965 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KY 3018290) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MO 2021038564) |
363LA2100X Nurse Practitioner, Acute Care (Licence: MO 2021038564) | |
Enumeration Date | 2021-10-04 |
Last Update Date | 2023-05-15 |