NPI | 1811475288 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KY 3016002) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: WV APRN89186-FNP-BC) |
Enumeration Date | 2018-07-30 |
Last Update Date | 2023-08-03 |