NPI | 1740417773 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KY 3015560) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: WV 75365) |
Enumeration Date | 2009-06-17 |
Last Update Date | 2021-01-14 |