NPI | 1811533862 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: KY 3013661) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: KY 3013661) |
Enumeration Date | 2019-11-25 |
Last Update Date | 2020-10-29 |