NPI | 1740942176 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KY 3016845) |
Additional Taxonomies | 163WG0000X Registered Nurse, General Practice (Licence: KY 3016845) |
Enumeration Date | 2021-10-13 |
Last Update Date | 2024-08-22 |