| NPI | 1376961425 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: KY 3008730) |
| Additional Taxonomies | 2088P0231X (Licence: KY 3008730) |
| Enumeration Date | 2014-04-04 |
| Last Update Date | 2020-09-25 |