NPI | 1932530524 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KY 3001912) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IN 28098081A) |
Enumeration Date | 2013-12-06 |
Last Update Date | 2013-12-06 |