| NPI | 1063650281 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: KY 3002492) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: KY 3002492) |
| Enumeration Date | 2009-01-26 |
| Last Update Date | 2024-01-10 |