NPI | 1700354826 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KY 3012689) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: WV 91087) |
Enumeration Date | 2018-11-06 |
Last Update Date | 2023-08-08 |