NPI | 1932775574 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NC 5014481) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: KY 4012658) |
Enumeration Date | 2021-06-03 |
Last Update Date | 2024-02-09 |