| NPI | 1689966020 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KY 3011639) |
| Additional Taxonomies | 163WL0100X Registered Nurse, Lactation Consultant (Licence: KY 1052843) |
| 363LP0200X Nurse Practitioner, Pediatrics (Licence: KY 3011639) | |
| Enumeration Date | 2011-05-04 |
| Last Update Date | 2022-07-21 |