| NPI | 1326036658 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: AL 1-149075) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: KY 1105856) |
| 363LP0200X Nurse Practitioner, Pediatrics (Licence: KY 20041080) | |
| 363L00000X Nurse Practitioner (Licence: KY 4540P) | |
| Enumeration Date | 2005-10-11 |
| Last Update Date | 2015-03-17 |