NPI | 1972260644 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KY 3014467) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: KY 3014467) |
Enumeration Date | 2021-11-17 |
Last Update Date | 2021-12-22 |