NPI | 1972781474 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KY 5475P) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: KY 3005475) |
Enumeration Date | 2008-02-06 |
Last Update Date | 2012-03-30 |