NPI | 1578777314 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KY 3003585) |
Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: KY 3003585) |
Enumeration Date | 2007-05-10 |
Last Update Date | 2017-02-09 |