NPI | 1932389590 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KY 3005345) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: KY 3005345) |
363LA2200X Nurse Practitioner, Adult Health (Licence: KY 3005345) | |
Enumeration Date | 2007-11-11 |
Last Update Date | 2020-11-03 |