| NPI | 1326284209 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: KY 3005861) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: KY 3005861) |
| 363LF0000X Nurse Practitioner, Family (Licence: KY 3005861) | |
| Enumeration Date | 2008-12-26 |
| Last Update Date | 2023-07-27 |