NPI | 1790871218 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KY 3004938) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: KY 1091753) |
Enumeration Date | 2006-10-04 |
Last Update Date | 2024-01-11 |