NPI | 1649642406 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: KY 3009737) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: KY 3009737) |
363L00000X Nurse Practitioner (Licence: IN 71007956A) | |
Enumeration Date | 2015-10-20 |
Last Update Date | 2020-04-21 |