NPI | 1649604232 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024173122) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: KY 3008216) |
163WM0705X Registered Nurse, Medical-Surgical (Licence: KY 300821) | |
Enumeration Date | 2013-08-30 |
Last Update Date | 2016-04-04 |