| NPI | 1396074126 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: KY 3006226) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: KY 3006226) |
| Enumeration Date | 2009-12-07 |
| Last Update Date | 2023-12-12 |