| NPI | 1295201770 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner Pediatrics (Licence: KY 3012544) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: KY 3012544) |
| 363LF0000X Nurse Practitioner Family (Licence: KY 3012544) | |
| Enumeration Date | 2018-10-22 |
| Last Update Date | 2020-10-16 |