NPI | 1700408671 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KY 3014606) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: KY 3014606) |
Enumeration Date | 2020-05-13 |
Last Update Date | 2022-02-10 |