NPI | 1518371152 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KY 3008692) |
Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: KY 3008692) |
Enumeration Date | 2014-06-11 |
Last Update Date | 2021-09-16 |