| NPI | 1477388890 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: KY 4027308) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: KY 4027308) |
| 363L00000X Nurse Practitioner (Licence: KY 4027308) | |
| Enumeration Date | 2024-09-05 |
| Last Update Date | 2024-12-02 |