NPI | 1760678577 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KY 3009213) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: KY 1093689) |
Enumeration Date | 2007-09-15 |
Last Update Date | 2020-03-21 |