NPI | 1639834187 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KY 3016906) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: KY F10210325) |
Enumeration Date | 2021-11-01 |
Last Update Date | 2021-12-08 |