NPI | 1619620291 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KY 3017603) |
Additional Taxonomies | 163WG0000X Registered Nurse, General Practice (Licence: KY 1164120) |
Enumeration Date | 2022-02-02 |
Last Update Date | 2022-04-12 |