NPI | 1770061301 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: KY 3012221) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: OH APRN.CNP.023382) |
Enumeration Date | 2018-08-06 |
Last Update Date | 2020-07-27 |