| NPI | 1689258097 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner Pediatrics (Licence: KY 3016077) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner Pediatrics (Licence: KY 201914782) |
| Enumeration Date | 2021-05-11 |
| Last Update Date | 2021-06-14 |