| NPI | 1629527635 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0222X Nurse Practitioner, Pediatrics, Critical Care (Licence: KY 3016508) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: KY 3016508) |
| 363LP0222X Nurse Practitioner, Pediatrics, Critical Care (Licence: MN CNP 4822) | |
| Enumeration Date | 2016-10-03 |
| Last Update Date | 2021-09-08 |