| NPI | 1215656459 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0200X Nurse Practitioner Pediatrics (Licence: KY 3008404) |
| Additional Taxonomies | 163WP0200X Registered Nurse Pediatrics (Licence: KY 1138022) |
| Enumeration Date | 2022-08-23 |
| Last Update Date | 2022-08-23 |