| NPI | 1104955152 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0222X Nurse Practitioner, Pediatrics, Critical Care (Licence: KY 3004458) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: KY 3004458) |
| 363LP0200X Nurse Practitioner, Pediatrics (Licence: KY 3004458) | |
| Enumeration Date | 2007-03-05 |
| Last Update Date | 2014-09-04 |