| NPI | 1215560677 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KY 3014335) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: KY 3014335) |
| 363LP0200X Nurse Practitioner, Pediatrics (Licence: KY 3014335) | |
| Enumeration Date | 2020-02-13 |
| Last Update Date | 2020-07-29 |