NPI | 1821872078 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KY 4042010) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: KY 1170458) |
Enumeration Date | 2023-08-21 |
Last Update Date | 2025-06-16 |