NPI | 1982235016 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KY 3014068) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: WV 105047) |
Enumeration Date | 2020-01-28 |
Last Update Date | 2020-01-28 |