| NPI | 1285764829 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: KY 3005162) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: KY 5162P) |
| Enumeration Date | 2007-03-06 |
| Last Update Date | 2024-08-02 |