| NPI | 1083967285 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: KY 3007620) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: KY 1112776) |
| 364SP0200X Clinical Nurse Specialist, Pediatrics (Licence: KY 3007620) | |
| Enumeration Date | 2012-10-25 |
| Last Update Date | 2021-10-20 |