| NPI | 1073717922 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: KY 3014246) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: WV 3014246) |
| 363LP0200X Nurse Practitioner, Pediatrics (Licence: OH NP-08588) | |
| 363LP0200X Nurse Practitioner, Pediatrics (Licence: MI 4704340015) | |
| Enumeration Date | 2007-06-13 |
| Last Update Date | 2023-01-10 |