| NPI | 1003956426 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: KY 3004675) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: KY 1053308) |
| 363LP0200X Nurse Practitioner, Pediatrics (Licence: KY 4675P) | |
| Enumeration Date | 2007-02-07 |
| Last Update Date | 2014-09-12 |