| NPI | 1558863167 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: KY 3012112) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner Pediatrics (Licence: KY 3012112) |
| Enumeration Date | 2018-02-28 |
| Last Update Date | 2018-03-09 |