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 |