| NPI | 1407007388 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: KY 3005746) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: KY 5746P) |
| 363L00000X Nurse Practitioner (Licence: KY 5746P) | |
| 363L00000X Nurse Practitioner (Licence: KY 3005746) | |
| Enumeration Date | 2008-10-09 |
| Last Update Date | 2015-01-20 |