NPI | 1982289815 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KY 4041543) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: TN 38766) |
Enumeration Date | 2021-03-11 |
Last Update Date | 2025-09-04 |