| NPI | 1689665333 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: KY 1038432) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: KY 308P) |
| 363LP0200X Nurse Practitioner Pediatrics (Licence: KY 1038432) | |
| 363LP0200X Nurse Practitioner Pediatrics (Licence: KY 308P) | |
| Enumeration Date | 2005-11-02 |
| Last Update Date | 2007-07-08 |