| NPI | 1194793760 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner Pediatrics (Licence: KY 3004567) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: KY 4567P) |
| Enumeration Date | 2006-03-09 |
| Last Update Date | 2019-05-22 |