NPI | 1932463551 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KY 3008881) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: OH 13372) |
Enumeration Date | 2012-06-28 |
Last Update Date | 2017-03-07 |