NPI | 1902784770 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KY 4045407) |
Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: KY 4045407) |
Enumeration Date | 2025-08-21 |
Last Update Date | 2025-08-21 |