NPI | 1679171318 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KY 3015052) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MD R249027) |
363LF0000X Nurse Practitioner, Family (Licence: MD AC003455) | |
Enumeration Date | 2020-10-14 |
Last Update Date | 2024-08-23 |