| NPI | 1265804900 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LA2100X Nurse Practitioner, Acute Care (Licence: KY 3011059)  | 
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: KY 3011059)  | 
| 363LP0222X Nurse Practitioner, Pediatrics, Critical Care (Licence: KY 3011059)  | |
| Enumeration Date | 2015-10-21 | 
| Last Update Date | 2023-06-15 |